Find information on thousands of medical conditions and prescription drugs.

Pacerone

Amiodarone belongs to a class of drugs called Vaughan-Williams Class III antiarrhythmic agent. It is used in the treatment of a wide range of cardiac tachyarhthmias, including both ventricular and supraventricular (atrial) arrhythmias. The chemical name for amiodarone is 2-butyl-3-benzofuranyl 4--3,5-diiodophenyl ketone hydrochloride. more...

Home

Pamelor

Parnate

Patanol

Pavulon

Paxil

PCE

Pentaerithrityl tetranitrate

Pentasa

Pentosan polysulfate sodium

Peridex

Pitocin

Plavix

Plendil

Pletal

Polyestradiol phosphate

Polymox

Portia

Pyridostigmine bromide

ViroPharma Incorporated

History

Amiodarone was initially developed in 1961 in Belgium as a treatment for angina. It was widely used throughout Europe as an anti-anginal medication, and was soon found to suppress arrhythmias.

Dr. Bramah Singh determined that amiodarone and sotalol belonged to a new class of antiarrhythmic agents (what would become the class III antiarrhythmic agents) that would prolong repolarization of the cardiac action potential. Based on this, the Argentinian physician Dr. Mauricio Rosenbaum began using amiodarone to treat his patients who suffered from supraventricular and ventricular arrhythmias, with impressive results. Based on papers written by Dr. Rosenbaum, physicians in the United States began prescribing amiodarone to their patients with potentially life-threatening arrhythmias in the late 1970s. By that time, amiodarone was commonly prescribed throughout Europe for the treatment of arrhythmias. Because amiodarone was not approved by the FDA for use in the United States at the time, physicians were forced to directly obtain amiodarone from pharmaceutical companies in Canada and Europe.

The FDA was reluctant to officially approve the use of amiodarone, since initial reports had shown increased incidence of serious pulmonary side-effects of the drug. In the mid 1980s, the European pharmaceutical companies began putting pressure on the FDA to approve amiodarone by threatening to cut the supply to the American physicians if it was not approved. In December of 1985, amiodarone was approved by the United States FDA for the treatment of arrhythmias. This makes amiodarone one of the few drugs approved by the FDA without rigorous randomized clinical trials.

Dosing

Amiodarone is available in oral and intravenous formulations. Orally, it is available under the trade names Pacerone^® (produced by Upsher-Smith Laboratories, Inc.) and Cordarone^® (produced by Wyeth-Ayerst Laboratories) in 200 mg and 400 mg tablets. It is also available in intravenous ampules and vials, typically in 150mg increments.

The dose of amiodarone administered is tailored to the individual and the dysrhythmia that is being treated. When administered orally, the bioavailability of amiodarone is quite variable. Absorption ranges from 22 to 95%, with better absorption when it is given with food.

Amiodarone is fat-soluble, and tends to concentrate in tissues including fat, muscle, liver, lungs, and skin. This confers a high volume of distribution (5000 liters in a 70kg adult) and a long half-life. Due to the long half-life of amiodarone, oral loading typically takes days to weeks.

Read more at Wikipedia.org

• [List your site here Free!]

Antioxidant vitamin supplements and cardiovascular disease risk reduction
From American Family Physician, 4/1/05 by Matthew J. Neff

The American Heart Association (AHA) has released a science advisory on the effects of antioxidant vitamin supplements on reducing the risk of cardiovascular disease. The full report appears in the August 3, 2004, issue of Circulation and is available online at http://circ.ahajournals.org/cgi/content/full/ 110/5/637.

The authors found that clinical trials generally have failed to demonstrate a beneficial effect of antioxidant supplements on cardiovascular morbidity and mortality. This lack of efficacy was demonstrated consistently for different doses of various antioxidants in diverse populations. Some smaller stud-ies did show benefits from [alpha]-tocopherol, [alpha]-tocopherol plus slow-release vitamin C, and vitamin C plus vitamin E on cardiovascular end points.

There is some evidence that antioxidant supplements may have adverse effects on cardiovascular end points. Some study results showed that antioxidant supplements may have interfered with the efficacy of statin-plus-niacin therapy, and that the addition of antioxidant vitamins blunted the expected rise in the protective high-density lipoprotein (HDL)-2 cholesterol and apolipoprotein A1 subfractions of HDL.

According to the advisory, the scientific data do not justify the use of antioxidant vitamin supplements for the prevention and treatment of cardiovascular disease. There are no consistent data to show that consuming micronutrients at levels exceeding those provided by a dietary pattern consistent with the AHA Dietary Guidelines will provide additional benefit. The authors state that this position is consistent with evidence-based guidelines for prevention of cardiovascular disease in women, which was released in 2004 by the AHA, and guidelines for patients with chronic stable angina released in 2002 from the American College of Cardiology. The advisory recommends achieving cardio-vascular risk reduction through long-term consumption of diets that are consistent with the AHA Dietary Guidelines and high in food sources of antioxidants and other cardioprotective nutrients, such as fruits, vegetables, whole grains, and nuts; long- term maintenance of a healthy body weight through balancing energy intake with regular physical activity; and attaining desirable blood cholesterol and lipoprotein profiles and blood pressure levels.

Medication Guide for Amiodarone

The U.S Food and Drug Administration (FDA) has mandated a medication guide for amiodarone. In 2004, approximately 3 million prescriptions were dispensed for amiodarone, a drug for heart arrhythmia. More than 90 percent of amiodarone prescriptions are filled with generic amiodarone. The medication guide was published by a manufacturer of branded amiodarone at the request of the FDA. The complete medication guide can be found online at http://www.wyeth.com/content/ShowLabeling.asp?id=470 and http://www.upshersmith.com/PDFs/Pacerone MedGuide.pdf.

Several factors may have led to the publication of the medication guide, including:

* The risks of using amiodarone as an antiarrhythmic agent. Serious side effects are associated with this agent (e.g., lung damage, liver damage, worse heartbeat problems) that can lead to death.

* Off-label prescribing for atrial fibrillation. The FDA has not approved amiodarone for the treatment of atrial fibrillation. Amiodarone is approved only for use in adults with ventricular arrhythmias (life-threatening heartbeat problems), for which other treatments did not work or were not tolerated.

* Concern that prescribing physicians and patients receiving amiodarone may not be fully informed of the risk of using this drug.

Physicians and patients may seek information about alternative medications to amio-darone that are approved by the FDA for the treatment of symptomatic atrial fibrillation without structural heart disease. Older patients may be at higher risk, because atrial fibrillation most commonly affects persons who are 50 years and older.

Return to Pacerone

Home

Contact

Resources

Exchange Links

ebay