IntroductionA drug based on amiodarone without the iodine. It does work to prevent atrial fibrillation with some potential for hepatic and renal toxicity and is known to be poorly tolerated in heart failure. The mortality increase in severe heart failure seems to be from heart failure itself as no pro-arrhythmic has as yet been shown. In elderly patients in permanent atrial fibrillation at increased risk of vascular disease the increased incidence of heart failure, stroke, and death outweighed any anti-arrhythmic benefit of the drug .
- Clinically stable adult patients with a history of, or current non-permanent atrial fibrillation to prevent recurrence, or to lower ventricular rate
Oral 400mg tab
- Permanent atrial fibrillation in elderly with risk of vascular disease
Cautions and Interactions
- QT interval prolongation
- Hepatitis - use has been related to hepatic failure
Little evidence of effect on QT interval. It belongs to all four Vaughan-Williams classes being a multi-channel blocker inhibiting the potassium currents (including IK (Ach), IKur, IKr, IKs) and thus prolonging cardiac action potential and refractory periods (Class III), an inhibitor of the sodium currents (Class Ib) and the calcium currents (Class IV) as well as being a non-competitive antagonist of adrenergic activity (Class II).
- ↑ Dale KM, White CM. Dronedarone: an amiodarone analog for the treatment of atrial fibrillation and atrial flutter. The Annals of pharmacotherapy. 2007 Apr; 41(4):599-605.(Link to article – subscription may be required.)
- ↑ Køber L, Torp-Pedersen C, McMurray JJ, Gøtzsche O, Lévy S, Crijns H, Amlie J, Carlsen J. Increased mortality after dronedarone therapy for severe heart failure. The New England journal of medicine. 2008 Jun 19; 358(25):2678-87.(Link to article – subscription may be required.)
- ↑ MHRA approved warning 21 Jan 2011
- ↑ FDA warning 14 Jan 2011