Formulary
Dronedarone: Indications, Dosing, Side Effects and Interactions
Dronedarone is a multi-channel blocking anti-arrhythmic drug.
MedNext Academy | 3 min read
Dronedarone: Indications, Dosing, Side Effects and Interactions
Dronedarone is a multi-channel blocking anti-arrhythmic drug.
Drug action
Dronedarone is a multi-channel blocking anti-arrhythmic drug.
Indications and dose
**Maintenance of sinus rhythm after cardioversion in clinically stable patients with paroxysmal or persistent atrial fibrillation, when alternative treatments are unsuitable (initiated under specialist supervision)**
- **Adult** (By Mouth): 400 mg twice daily.
Cautions
Coronary artery disease; correct hypokalaemia and hypomagnesaemia before starting and during treatment
Contraindications
Atrial conduction defects; bradycardia; complete bundle branch block; distal block; existing or previous heart failure or left ventricular systolic dysfunction; haemodynamically unstable patients; liver toxicity associated with previous amiodarone use; lung toxicity associated with previous amiodarone use; permanent atrial fibrillation; prolonged QT interval; second- or third- degree AV block; sick sinus syndrome (unless pacemaker fitted); sinus node dysfunction
Side effects
Common or very common Asthenia; bradycardia; congestive heart failure; diarrhoea; gastrointestinal discomfort; nausea; QT interval prolongation; skin reactions; vomiting Uncommon Interstitial lung disease; photosensitivity reaction; pulmonary fibrosis; taste altered Rare or very rare Hepatic disorders; vasculitis Side-effects, further information Liver injury Liver injury including life-threatening acute liver failure reported rarely; discontinue treatment if 2 consecutive alanine aminotransferase concentrations exceed 3 times upper limit of normal. Heart failure New onset or worsening heart failure reported. If heart failure or left ventricular systolic dysfunction develops, discontinue treatment. Pulmonary toxicity Interstitial lung disease, pneumonitis and pulmonary fibrosis reported. Investigate if symptoms such as dyspnoea or dry cough develop and discontinue if confirmed.
Interactions
**Other interactions (12):**
- Concomitant use of P-gp inhibitors may increase the exposure of relugolix, including certain anti-infective medicinal products (e.g.
- Diltiazem Dronedarone Not studied.
- Combinations requiring caution Combinations which can increase the effects of digoxin when co-administered: amiodarone, canagliflozin, daclatasvir, flibanserin, flecainide, prazosin, propafenone,...
- Given the limited clinical data available with dronedarone, co-administration with rivaroxaban should be avoided.
- Antiarrhythmics Amiodarone, Dronedarone Amiodarone, Dronedarone: Concentrations may be increased due to CYP3A4 inhibition by lopinavir/ritonavir.
- Examples include: Class IA antiarrhythmics (e.g.
Pregnancy
Manufacturer advises avoid-toxicity in animal studies.
Breast feeding
Manufacturer advises avoid-present in milk in animal studies.
Hepatic impairment
Manufacturer advises avoid in severe impairment.
Renal impairment
Avoid if creatinine clearance less than 30 mL/minute. M See Prescribing in renal impairment .
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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