Influence of concomitant medication on plasma concentration of amiodarone in patients with atrial fibrillation - A pilot study

Authors

DOI:

https://doi.org/10.15386/mpr-1130

Keywords:

amiodarone, plasma concentration, drug interaction, P-glycoprotein

Abstract

Background. Although amiodarone is a drug with many side effects, it is one of the most commonly used drugs in the treatment and prophylaxis of supraventricular and ventricular arrhythmias.

Aim. The purpose of this pilot study was to evaluate plasma concentrations of amiodarone in patients with atrial fibrillation (AF) and to identify possible drug-drug interactions between amiodarone and concomitant medications.

Method. A prospective observational study was conducted in 27 consecutive patients treated with amiodarone from May to July 2017 in a Clinical University Hospital. The patients included met our inclusion criteria. HPLC-UV was the device used to determine the plasma concentration of amiodarone.

Results. Only 51.8% of the patients had amiodarone plasma concentration within therapeutic interval (500-2500 ng/ml). The drugs associated to amiodarone in the therapeutic plan were diuretics, beta blockers, statins, antiplatelets, fluoroquinolones, non-steroidal anti-inflammatory drugs. We observed a statistically significant difference between the plasmatic concentrations of amiodarone in patients treated with furosemide vs. patients concomitantly treated with other drugs. Interactions between other mentioned drugs and amiodarone were not registered. We can report an underuse of amiodarone for more than 50% of the patients. Also, we found a significant interaction between furosemide and amiodarone, most likely through the interaction with MDR.

Conclusion. Furosemide may influence the pharmacokinetics of P-gp-interfering drugs. However, the relevance of these findings needs to be confirmed and further research is needed to characterize the interaction between amiodarone and furosemide.

Author Biographies

Maria Adriana Neag, Iuliu Hatieganu University of Medicine and Pharmacy

Pharmacology, Toxicology and Clinical Pharmacology

Dana Maria Muntean, Iuliu Hatieganu University of Medicine and Pharmacy

Pharmaceutical Technology and Biopharmaceutics

Alexandra Nacu, Iuliu Hatieganu University of Medicine and Pharmacy

Pharmacology, Toxicology and Clinical Pharmacology

Adrian Catinean, Iuliu Hatieganu University of Medicine and Pharmacy

Internal Medicine

Anca Farcas, Iuliu Hatieganu University of Medicine and Pharmacy

Internal Medicine

Stefan Vesa, Iuliu Hatieganu University of Medicine and Pharmacy

Pharmacology, Toxicology and Clinical Pharmacology

Corina Bocsan, Iuliu Hatieganu University of Medicine and Pharmacy

Pharmacology, Toxicology and Clinical Pharmacology

Laurian Vlase, Iuliu Hatieganu University of Medicine and Pharmacy

Pharmaceutical Technology and Biopharmaceutics

Anca Dana Buzoianu, Iuliu Hatieganu University of Medicine and Pharmacy

Pharmacology, Toxicology and Clinical Pharmacology

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Published

2019-04-16

How to Cite

1.
Neag MA, Muntean DM, Nacu A, Catinean A, Farcas A, Vesa S, Bocsan C, Vlase L, Buzoianu AD. Influence of concomitant medication on plasma concentration of amiodarone in patients with atrial fibrillation - A pilot study. Med Pharm Rep [Internet]. 2019 Apr. 16 [cited 2025 Oct. 5];92(2):129-33. Available from: https://medpharmareports.com/index.php/mpr/article/view/1130

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Section

Original Research