Dronedarone


Introduction

Dronedarone (Multaq) is a class III antiarrhythmic drug used in the treatment of paroxysmal and persistent atrial fibrillation and atrial flutter. There are structural similarities to amiodarone, however no iodine is present in the chemical structure of dronedarone which has resulted in dramatically reduced toxicity compared to amiodarone (see amiodarone toxicity), however a lower efficacy than amiodarone.

Indications

Dronedarone is used solely to maintain sinus rhythm in patients with paroxysmal and persistent atrial fibrillation and atrial flutter.

Adverse Effects

Hepatic dysfunction is the main concern. Rare cases of fulminant hepatic failure have been reported leading to a FDA advisory in January of 2011.

Bradycardia, heart failure, hypotension, QT prolongation.

Miscellaneous

Dronedarone is contraindicated if left ventricular systolic dysfunction is present since clinical trials showed an increase in deaths from heart failure.

Dronedarone is not indicated if atrial fibrillation or atrial flutter is permanent.

Dronedarone is not used for ventricular arrhythmias.