Influence of concomitant medication on plasma concentration of amiodarone in patients with atrial fibrillation - a pilot study.
P-glycoprotein
amiodarone
drug interaction
plasma concentration
Journal
Medicine and pharmacy reports
ISSN: 2668-0572
Titre abrégé: Med Pharm Rep
Pays: Romania
ID NLM: 101742144
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
02
08
2018
revised:
12
12
2018
accepted:
21
12
2018
entrez:
16
5
2019
pubmed:
16
5
2019
medline:
16
5
2019
Statut:
ppublish
Résumé
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. 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. 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. 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. 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.
Sections du résumé
BACKGROUND
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
OBJECTIVE
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
METHODS
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
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
CONCLUSIONS
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.
Identifiants
pubmed: 31086839
doi: 10.15386/mpr-1130
pii: cm-92-129
pmc: PMC6510352
doi:
Types de publication
Journal Article
Langues
eng
Pagination
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