| Drug Name: | Amiodarone (1951-25-3) |
|---|---|
| PubChem ID: | 2157 |
| SMILES: | CCCCC1=C(C2=CC=CC=C2O1)C(=O)C3=CC(=C(C(=C3)I)OCCN(CC)CC)I |
| InchiKey: | IYIKLHRQXLHMJQ-UHFFFAOYSA-N |
| Therapeutic Category: | Anti-Arrhythmia Agents, Cardiovascular Agents, Cytochrome P-450 CYP1A2 Inhibitors, Cytochrome P-450 CYP2C9 Inhibitors, Cytochrome P-450 CYP2D6 Inhibitors, Cytochrome P-450 CYP3A Inhibitors, Cytochrome P-450 Enzyme Inhibitors, Enzyme Inhibitors, Membrane Transport Modulators, Potassium Channel Blockers, Sodium Channel Blockers, Vasodilator Agents |
| Molecular Weight (dalton) | : | 645.319 |
| LogP | : | 6.9362 |
| Ring Count | : | 3 |
| Hydrogen Bond Acceptor Count | : | 4 |
| Hydrogen Bond Donor Count | : | 0 |
| Total Polar Surface Area | : | 42.68 |
This panel provides information on interacting drugs and their ADRs along with references
| Interacting drug | Toxicity | Interaction Type | Mechanism | Reference |
|---|---|---|---|---|
| ibutilide (122647-32-9) | Torsade De Pointes | Additive | Uncertain | Chemical cardioversion of atrial fibrillation or flutter with ibutilide in patients receiving amiodarone therapy |
| Lidocaine (137-58-6) | Seizure | Synergistic | An in vitro study has demonstrated that amiodarone may inhibit lidocaine metabolism competitively and vice versa. The interaction in vivo may be due to inhibition of the cytochrome P450 isoenzyme CYP3A4 by amiodarone and/'or its main metabolite desethylamiodarone | Amiodarone interaction with lidocaine |
| Acenocoumarol (152-72-7) | Bleeding | Antagonistic | Amiodarone inhibits the metabolism of Acenocoumarol, probably because it,and/'or its metabolite desethylamiodarone, inhibit the cytochrome P450isoenzyme CYP2C9, CYP3A4 and CYP1A4 | Dangers of amiodarone and anticoagulant treatment (Pubmed ID 6788267) |
| Diltiazem (42399-41-7) | Bradycardia | Additive | Uncertain | Sinus arrest and hypotension with combined amiodarone-diltiazem therapy |
| Disopyramide ((3737-09-5)) | Pr Prolongation | Additive | Amiodarone is a class III antiarrhythmic and can prolong the QT interval. Disopyramide is a class Ia antiarrhythmic and also prolongs the QT interval. Their additive effects can result in the development of torsade de pointes arrhythmias | Harmful interactions of amiodarone and class I anti-arrhythmia agents |
| Erythromycin (114-07-8) | Torsade De Pointes | Additive | Amiodarone alone can prolong the QT interval and increase the risk of torsade de pointes. Intravenous erythromycin is known to prolong the QT interval. Amiodarone and erythromycin may therefore have additive effects on the QT interval | Erythromycin-induced long QT syndrome: concordance with quinidine and underlying cellular electrophysiologic mechanism |
| Fentanyl (437-38-7) | Bradycardia | Antagonistic | Fentanyl is a substrate for the cytochrome P450 isoenzyme CYP3A4, and that amiodarone might inhibit CYP3A4, thereby increasing the toxicity of fentanyl | Amiodarone-induced complications during coronary artery surgery |
| Gatifloxacin (112811-59-3) | Arrhythmia | Additive | Not established | Rates of torsades de pointes associated with ciprofloxacin, ofloxacin, levofloxacin, gatifloxacin, and moxifloxacin |
| Halothane (151-67-7) | Vasodilator Effects | Additive | In vitro and in vivo studies in animals suggest that amiodarone has additive cardiodepressant and vasodilator effects with volatile anaesthetics such as halothane, enflurane and isoflurane | Should oral amiodarone be used for sustained ventricular tachycardia in patients requiring open-heart surgery? |
| Levofloxacin (100986-85-4) | Torsade De Pointes | Additive | Not established | Quinolone-induced QT interval prolongation: a not-so-unexpected class effect |
| Lithium (7439-93-2) | Hypothyroidism | Antagonistic | Not established | Sudden hypothyroidism and amiodarone-lithium combination: an interaction |
| Loratadine (79794-75-5) | Torsade De Pointes | Antagonistic | Uncertain | Torsades de pointes and QT prolongation due to a combination of loratadine and amiodarone |
| Oxygen (7782-44-7) | Respiratory Distress Syndrome | Additive | Not established | Fatal postoperative amiodarone pulmonary toxicity |
| Propranolol (525-66-6) | Bradycardia | Additive | Not understood. The clinical picture is that of excessive beta-blockade, and additive pharmacodynamic effects are possible | Amiodarone and propanolol: a dangerous combination |
| Sparfloxacin (110871-86-8) | Torsade De Pointes | Additive | Not established | Overview of electrocardiographic and cardiovascular safety data for sparfloxacin Sparfloxacin Safety Group |
| Trazodone (19794-93-5) | Torsade De Pointes | Additive | Not established | QT prolongation and polymorphous ventricular tachycardia associated with trasodone-amiodarone combination |
| Phenprocoumon (435-97-2) | Bleeding | Antagonistic | Amiodarone inhibits the metabolism of Phenprocoumon, probably because it,and/'or its metabolite desethylamiodarone, inhibit the cytochrome P450isoenzyme CYP2C9, CYP3A4 and CYP1A3 | Dangers of amiodarone and anticoagulant treatment |
| Cyclophosphamide (50-18-0) | Pulmonary Toxicity | Synergistic | Not understood | Amiodarone pulmonary toxicity Recognition and pathogenesis |
| Procainamide (51-06-9) | Prolongs The Qt Interval | Additive | The mechanism behind the pharmacokinetic interaction is not understood. The QT prolonging effects of the two drugs would be expected to be additive. | Effect of amiodarone on serum quinidine and procainamide levels |
| Flecainide (54143-55-4) | Torsade De Pointes | Synergistic | Amiodarone inhibits the cytochrome P450 isoenzyme CYP2D6, so that the flecainide is metabolised by the liver more slowly. Amiodarone also inhibits CYP2D6-independent mechanisms of flecainide elimination | Flecainide and amiodarone interaction |
| Quinidine (56-54-2) | Torsade De Pointes | Additive | The mechanism behind the pharmacokinetic interaction is not understood. The QT prolonging effects of the two drugs would be expected to be additive. | Dangerous interaction between amiodarone and quinidine |
| Phenytoin (57-41-0) | Ataxia | Synergistic | Uncertain. It seems possible that amiodarone inhibits the liver enzymes concerned with the metabolism of phenytoin, resulting in a rise in its serum levels | Steady-state interaction between amiodarone and phenytoin in normal subjects |
| Warfarin (81-81-2) | Bleeding | Antagonistic | Amiodarone inhibits the metabolism of warfarin, probably because it,and/'or its metabolite desethylamiodarone, inhibit the cytochrome P450isoenzyme CYP2C9, CYP3A4 and CYP1A2 | Interaction between warfarin sodium and amiodarone |
This panel provides drug-protein interaction and their ADRs along with references
This panel provides drug-food interactions and their ADRs along with references
| Food | Toxicity | Reference |
|---|---|---|
| Grapefruit Juice | Arrhythmia | Food–drug interaction: grapefruit juice augments drug bioavailabilityFmechanism, extent and relevance |
| Grapefruit Juice | Torsade De Pointes | Grapefruit-medication interactions: forbidden fruit or avoidable consequences? |
This panel provides information on metabolites and their ADRs along with references
| Metabolite | Toxicity | Place of Metabolism | Mechanism | Reference |
|---|
This panel provides information on drug category