The potential complications from amiodarone are legion and therefore monitoring is important
Before treatment with amiodarone:
- patients should have careful clinical assessment, measurements of liver enzymes, thyroid function tests and serum potassium, an ECG and chest X-ray
After treatment with amiodarone has commenced:
- it is advised that all patients taking amiodarone should have their liver function tests and thyroid function tests checked every six months (1,2). Also they should possibly have potassium levels monitored 6 monthly (2).
- a Drug and Therapeutics Bulletin review suggests that eye examinations should be reserved for patients reporting visual symptoms (2) - this contrasts with other advice (1) which suggests that patients should have their eyes checked annually by slit examination.
- at the first hint of worsening of breathlessness or cough organise lung function tests as amiodarone can cause fibrosing alveolitis. Symptoms suggestive of pulmonary toxicity or hyperthyroidism require urgent referral (2)
- patients should be advised to limit sunlight exposure and to use a sunscreen.
Reference:
- MeReC Bulletin (2002), 12 (5), 17-20.
- Drug and Therapeutics Bulletin (2003), 41 (2), 9-12.