DÄ internationalArchive14/2008Amiodarone-Induced Thyorid Dysfunction: Interactions Need to Be Stated More Precisely


Amiodarone-Induced Thyorid Dysfunction: Interactions Need to Be Stated More Precisely

Dtsch Arztebl Int 2008; 105(14): 263. DOI: 10.3238/arztebl.2008.0263a

Meyer, F P

LNSLNS From a pharmacological perspective, this interesting article requires two "refinements" to the section on interactions.
Mention is made of "digitalis," without any further differentiation. There is no such preparation – it is either digoxin or digitoxin. Both drugs – combined with amiodarone – can trigger substantial bradycardia and atrioventricular conduction disturbances. The same is true for combinations with beta blockers or calcium antagonists of the verapamil or diltiazem type. Pharmacokinetic interactions, however, arise only between amiodarone and digoxin, as a result of the plasma concentration of digoxin. If this occurs, digoxin concentrations will have to be monitored regularly or the patient will have to be switched to digitoxin.
The term "statins" is also too general. Only atorvastatin, lovastatin, und simvastatin, and to a limited extent fluvastatin, are biotransformed by cytochrome P4503A4. Pravastatin, which is mostly sulfated, can be combined with amiodarone without any problem.
The current data situation does not permit any conclusions about whether amiodarone will be made obsolete by dronedarone one day, as the authors hypothesize in their outlook. We will have to wait for the results of the DIONYSOS and ATHENA studies.
DOI: 10.3238/arztebl.2008.0263a

Prof. Dr. med. Frank P. Meyer
Magdeburger Str. 29
39167 Groß Rodensleben, Germany