NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Amiodarone and dronedarone

Amiodarone and dronedarone are both included in the NHSGGC Total Formulary restricted to specialist initiation.

 

Amiodarone is usually the first choice. Patients receiving amiodarone therapy should be provided with information on potential adverse effects.  The prescriber who initiates the drug should ensure that baseline assessments (pulmonary function (including transfer factor of carbon monoxide), TFTs and LFTs) are undertaken and the drug is titrated to the minimum effective dose. In current practice, once the patient has been stabilised on the minimum effective dose, the on-going monitoring (TFTs and LFTs every six months) is the responsibility of the GP if the patient has been discharged from cardiology follow-up. Patients with new or increasing cough or breathlessness on amiodarone should be considered for prompt referral for respiratory evaluation.

 

Dronedarone is restricted for the prevention of recurrence of atrial fibrillation in patients in whom beta-blockers, class 1c drugs and amiodarone are contraindicated, ineffective or not tolerated and who do not have a diagnosis of heart failure. Dronedarone should only be initiated and monitored under specialist supervision and requires LFT monitoring before initiation, during titration and throughout treatment. In cases where GPs continue prescribing, associated monitoring should continue to be the responsibility of the cardiology clinic.

 

Further information is available here.

 

 

 

Published 10/11/2016