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Oral amiodarone: historical overview and development

P T Pollak1

  • 1Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

Pharmacotherapy
|December 17, 1998
PubMed
Summary

Amiodarone, an antiarrhythmic drug, evolved from initial enthusiasm to concerns over toxicity, but is now reaccepted. Optimized regimens have improved its value in treating arrhythmias.

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Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Therapeutics

Background:

  • Amiodarone emerged as a significant antiarrhythmic agent in the late 20th century.
  • Initial perceptions of amiodarone as an ideal agent were tempered by challenges in understanding its pharmacokinetics and adverse effects.

Purpose of the Study:

  • To trace the historical trajectory of amiodarone.
  • To analyze its electrophysiologic, pharmacologic, and pharmacokinetic profiles.
  • To examine the evolving clinical perceptions and therapeutic role of amiodarone.

Main Methods:

  • Comprehensive review of existing medical literature.
  • Analysis of historical data and clinical studies on amiodarone.

Main Results:

  • Amiodarone exhibits multi-class antiarrhythmic properties (primarily Class III).
  • Early use was hampered by variable absorption, slow onset, and toxicity at higher doses.
  • Re-evaluation in the 1990s with optimized dosing led to its reacceptance due to efficacy without increased mortality.

Conclusions:

  • Amiodarone remains a valuable and increasingly important therapeutic option for managing cardiac arrhythmias.
  • Further research is needed to refine optimal dosing, monitoring markers, and dose-response relationships.

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