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MagazineOctober 1999 (Vol. 10 Issue 7)Cordarone

If you have a life threatening condition, the chances are that the drug selected to treat you will be

If you have a life threatening condition, the chances are that the drug selected to treat you will be. . . life threatening. Drastic measures for drastic times, you might say. Or perhaps: if the illness doesn't get you, the drugs will.

Take, for instance, the drug Cordarone (amiodarone), perhaps more appropriately known in the UK as Cordarone X. It's one of a new generation of drugs for treating arrhythmia, or irregular heart beat.

The Physicians' Desk Reference (PDR), the US drugs bible, warns that the drug has life threatening side effects, and so is only suitable for patients with a life threatening condition. The PDR recommends that the drug should be administered, initially at least, in hospital, and under very careful supervision. Only doctors who specialise in arrythmia should be prescribing the drug.

Its warning was endorsed recently by a new study which found that the drug also causes thyroid dysfunction. Among 92 patients, one third developed thyroid side effects, which makes it particularly dangerous for people suffering with a congenital heart condition. Yes, that's right the very people who are supposed to take the drug (Circulation, 1999; 100: 149-54).

The thyroid problem is a new one. Researchers already knew that Cordarone produces fatal pulmonary toxicity in 10 per cent of all patients, while liver injury is common.

Of course, like other similar drugs, it can make the arrhythmia worse, and has done so in around five per cent of patients. Significant heart block has been reported in a similar percentage.

So, all in all, you could say the drug's not for the faint hearted. But who then should take it?

Heart disease: it's in the water

Drug interactions

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