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Interactions

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Amiodarone is metabolised by hepatic cytochrome P450 3A4(CYP 3A4) isoenzyme:

  • concomitant administration of CYP 3A4 inhibitors should either be avoided or used only with caution
  • CYP 3A4 inducers (e.g. carbamazepine, rifampicin) may lead to a reduction in amiodarone's plasma concentration and therefore reduce efficacy
  • amiodarone itself inhibits CYP 3A4 and therefore will increase plasma concentrations of drugs such as ciclosporin, phenytoin and verapamil

Other important interactions with amiodarone include:

  • potentiation of the effects of warfarin (inhibits metabolism via CYP 3A4)

  • reduces excretion of digoxin (leads to increased plasma concentration)

  • contra-indicated with other drugs that prolong the QT interval (e.g. disopyramide, quinidine, procainamide); only specialists should co-prescribe and monitor such drug therapy

Reference:

  1. Drug and Therapeutics Bulletin (2003), 41 (2), 9-12.

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