Noncardiac side-effects of long-term oral amiodarone in the elderly

Amiodarone is a powerful anti-arrhythmic drug. However, its use is somewhat limited by side-effects. No study examining side-effects specifically in elderly patients exists. We have reviewed noncardiac side-effects in 61 elderly patients on long-term oral amiodarone treatment (follow-up 3-66 months). The most troublesome side-effect was hypothyroidism (nine patients, 15%). No cases of frank hyperthyroidism were seen. Elevation of aspartate transaminase (AST) was common (16 patients, 26%), but generally mild and transient. Photosensitivity occurred in six patients (10%). Corneal deposits were common but gave rise to symptoms in only one patient. Two patients reported tremor. Hypothyroidism appeared to be more common and photosensitivity less common than in previously reported series in younger adults. Possible reasons for this are discussed. It is our policy to continue to prescribe amiodarone to elderly patients, regulate monitoring for adverse effects is however mandatory.