Dronedarone (Multaq)

Agent used mainly for the indication of cardiac arrhythmias.

A benzofuran derivative related to amiodarone.

An alternative to amiodarone for the treatment of atrial fibrillation and atrial flutter in people whose hearts have either returned to normal rhythm or who undergo drug therapy or electric shock treatment to maintain normal rhythm.

Associated with a possible increase in heart failure deaths, in patients with moderate to severe CHF, and is contraindicated in patients with NYHA Class IV heart failure, or NYHA Class II–III heart failure with a recent decompensation requiring hospitalization or ref2242al to a specialized heart failure clinic.

Rare cases of severe liver damage associated with the use of dronedarone.

Unlike amiodarone, iodine moieties are not present, reducing toxic effects on the thyroid and other organs.

A methylsulfonamide group added to the drug sreduce solubility in fats and reduces neurotoxic effects.

Has class III antiarrhythmic activity in clinical trials.

Less lipophilic than amiodarone, and has a much smaller volume of distribution.

Has a half-life of 24 hour in contrast to amiodarone which has a half-life of several weeks.

Dronedarone is a non-iodinated class III anti-arrhythmic drug which helps patients return to normal sinus rhythm.

Treatment for AF is also known to reduce associated mortality and hospitalizations compared to other similar antiarrhythmic agents.

Significantly more effective than placebo in maintaining sinus rhythm, with no difference in lung and thyroid function in the short term.

Use in AF shows a significant reduction in the rate of stroke.

Compared with placebo more likely to develop bradycardia and QT-interval prolongation, Nausea, diarrhea, rash, and creatinine elevation.

Iincreases rates of heart failure, stroke, and death from cardiovascular causes in patients with permanent a trial fibrillation.

Has been used in preparing patients for electro-conversion to sinus rhythm.

Reduces risk of cardiovascular hospitalization in patients with paroxysmal or persistent atrial fibrillation or atrial flutter, with recent atrial fibrillation or flutter and age greater than 70 years, hypertension, diabetes, prior cardiovascular accident, left atrial diameter > 50 mm or left ventricular ejection fraction <40%.

Contraindicated in patients with NYHA Class IV heart failure, or NYHA class II-III heart failure with a recent decompensation requiring hospitalization, second or third degree heart block, or sick sinus syndrome, bradycardia < 50 beats per minute, concomitant use of CYP 3A inhibitors, concomitant use of of drugs that prolong QT intervals, and severe hepatic impairment.

Associated with increased risk of death, stroke and heart failure in patients with decompensated heart failure or permanent atrial fibrillation.

Contraindicated in patients with symptomatic heart failure with recent decompensation requiring hospitalization or NYHA Class IV heart failure, with a doubling the risk of death in these patients.

Contraindicated in patients in atrial fibrillation who will not or cannot be cardioverted into normal sinus rhythm.

In patients with permanent AFib, it doubles the risk of death, stroke, and hospitalization for heart failure.

Dose 400 mg BID po.

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