Hepatic dysfunction in patients receiving intravenous amiodarone

Ali Hashmi, Nicole R. Keswani, Sharon Kim, David Y. Graham

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objectives Amiodarone is a commonly used antiarrhythmic drug. Hepatotoxicity following chronic oral administration occurs in 1% to 3% of patients. Hepatotoxicity following intravenous (IV) administration is infrequent but may be associated with dramatic increases in serum transaminases. We describe the incidence of liver toxicity among patients receiving IV amiodarone during a 5-year period. Methods This was a single-center retrospective review of patients receiving IV amiodarone for any cause. The outcome measures were development of elevated serum transaminases and the relation of transaminitis to all-cause 30-day mortality. Results A total of 1510 patients received amiodarone intravenously between 2005 and 2011; 77 (5%) developed elevated liver enzymes. Enzyme elevation was divided into mild (100-300 IU/L), moderate (300-1000 IU/L), and severe (>1000 IU/L). The median alanine aminotransferase was 189 (37-10,006) IU/L and aspartate aminotransferase was 253 (84-12,005) IU/L. The 30-day mortality among those with transaminitis was 22%; however, no patient died of amiodarone-related liver disease. Conclusions Amiodarone can cause severe elevation in liver enzymes. The incidence of severe transaminitis is low; deaths following IV amiodarone are rarely caused by drug-induced liver failure.

Original languageEnglish (US)
Pages (from-to)83-86
Number of pages4
JournalSouthern Medical Journal
Volume109
Issue number2
DOIs
StatePublished - Feb 1 2016
Externally publishedYes

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Keywords

  • amiodarone
  • arrhythmia
  • atrial fibrillation
  • hepatotoxicity
  • intravenous
  • mortality
  • polysorbate 80

ASJC Scopus subject areas

  • Medicine(all)

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