Abstract CPC-106 Table 1
Advice for avoiding Drug-Related Problems DRPs due to treatment with amiodarone
Warfarin Reduce/give half-dose warfarin at start-up. Monitor the INR values (1)
Digitoxin Give half dose digitoxin/digoxin and monitor digitoxin/digoxin determined by procedure (2)
Simvastatin No doses above 20 mg or switch to another statin. (3)
Atorvastatin Note the dose! No clear recommendations, but maximum 40 mg
Metoprolol Bradycardia? The dose may be adjusted (4)
General advice
When admitted from other hospitals
Note in the drug curve if recently treated with amiodarone!
Discharge summaries
Explain why the GP should follow up the blood values; INR, digitoxin/digoxin and possibly CK.
1. Edvin SB et al, An evaluation of early pharmacodynamic response after simultaneous initiation of warfarin and amiodarone.
2. Laer S et al, Digitoxin intoxication during concomitant use of amiodarone.
3. Marot A et al, Concomitant use of simvastatin and amiodarone resulting in severe rhabdomyolysis: a case report and literature review
4. Fukumoto et al, Effect of amiodarone on the serum concentration/dose ratio of metoprolol in patients with cardiac arrhythmias