Key result
Intravenous amiodarone triggers acute liver and renal failure within 24 hours, resolving after discontinuation.
Why the study?
Acute liver and renal failure as a rare adverse effect exclusive to intravenous amiodarone is not well characterized and differs from oral amiodarone toxicity.
Case Report (n=1)
Hyperacute liver and renal failure is a rare adverse effect of IV amiodarone that resolves upon discontinuation, and may not preclude the subsequent use of oral amiodarone.
Answers are grounded in this paper and cite their sources.
Clinicians should monitor for acute hepatorenal failure with IV amiodarone; leaves open confirmation of a distinct toxicity profile versus oral formulation.
Amiodarone is an antiarrhythmic drug which is highly effective against a wide spectrum of ventricular tachyarrhythmias making it irreplaceable in certain group of patients. We report an unusual case of acute liver and renal failure within 24 hours of initiation of intravenous (IV) amiodarone which resolved after stopping the medication. The mechanism of acute liver and renal toxicity is not clearly known but is believed to be secondary to amiodarone induced (relative) hypotension, idiosyncratic reaction to the drug, and toxicity of the vector that carries the medication, polysorbate-80. In this case review, we discuss the hyperacute drug toxicity caused by IV amiodarone being a distinctly different entity compared to the adverse effects shown by oral amiodarone and support the suggestion that oral amiodarone can be safely administered even in patients who manifest acute hepatitis with the IV form.
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Paudel et al. (2016) conducted a case report in Acute liver and renal failure (n=1). Intravenous (IV) amiodarone was evaluated on Acute liver and renal failure. Intravenous amiodarone administration caused acute liver and renal failure within 24 hours, which resolved upon discontinuation, suggesting a distinct toxicity profile from the oral formulation.
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