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amiodarone (cont.)

Amiodarone also can interact with tricyclic antidepressants (for example, amitriptyline, Elavil), or phenothiazines (for example, chlorpromazine, Thorazine) and potentially cause serious arrhythmias.

Amiodarone interacts with warfarin (Coumadin) and increases the risk of bleeding. The bleeding can be serious or even fatal. This effect can occur as early as 4-6 days after the start of the combination of drugs or can be delayed by a few weeks.

Amiodarone can interact with some cholesterol-lowering medicines of the "statin" class, such as simvastatin (Zocor), atorvastatin (Lipitor), and lovastatin (Mevacor), increasing the risk of severe muscle breakdown and kidney failure or liver disease. This interaction is dose-related, meaning that lower doses of statins are safer than higher doses when used with amiodarone. An alternative statin, pravastatin (Pravachol), does not share this interaction and is safer in patients taking amiodarone.

Amiodarone inhibits the metabolism of dextromethorphan, the cough suppressant found in most over-the-counter (and some prescription) cough and cold medications (for example, Robitussin-DM). Although the significance of the interaction is unknown, these two drugs probably should not be taken together if possible.

Reference: FDA Prescribing Information


Last Editorial Review: 11/14/2007




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