Is amiodarone safe in pregnancy?

Amiodarone can cause fetal harm when administered to a pregnant woman. Fetal exposure may increase the potential for adverse experiences including cardiac, thyroid, neurodevelopmental, neurological and growth effects in neonate.

Does amiodarone affect hypothyroidism?

Amiodarone can lead to both hypothyroidism (amiodarone-induced hypothyroidism) and less commonly hyperthyroidism (amiodarone-induced thyrotoxicosis) and relates to high iodine content within the molecule as well as to several unique intrinsic properties of amiodarone.

How does amiodarone cause hypothyroid?

Amiodarone induces alterations in thyroid hormone levels by actions on thyroidal secretion, on the peripheral tissues, and probably also on the pituitary gland. These actions result in elevations in serum T4 and rT3 concentrations, transient increases in TSH concentrations, and decreases in T3 concentrations.

What are the effects of amiodarone on thyroid?

Data synthesis: Amiodarone can have many effects on thyroid function test results, even in the absence of hyperthyroidism or hypothyroidism. It may cause an increase in serum levels of thyroxine, reverse triiodothyronine, and thyroid-stimulating hormone and a decrease in serum triiodothyronine levels.

Can amiodarone cross placenta?

Amiodarone, its main metabolite (desethylamiodarone) and iodine are transferred, albeit incompletely, through the placenta, resulting in a relevant fetal exposure to the drug and iodine overload.

What antiarrhythmic drugs are safe in pregnancy?

Adenosine is generally safe to use in pregnancy, and is the drug of choice for acute termination of maternal supraventricular tachycardia. Digoxin has a long track record of treating both maternal and fetal arrhythmias, and is one of the safest antiarrhythmics to use during pregnancy.

Does levothyroxine interact with amiodarone?

Interactions between your drugs Amiodarone may reduce the effects of levothyroxine. Contact your doctor if your symptoms worsen or your condition changes. Your doctor may be able to adjust the dose of levothyroxine or prescribe alternatives that do not interact.

How long does it take amiodarone to get out of your system?

Amiodarone has a very long half-life (this is the time it takes for 50% of a dose of amiodarone to be eliminated by the body) of 15 to 142 days. It also has an active metabolite, desethylamiodarone that has a half-life of 75 days.

Can you take amiodarone with levothyroxine?

Can amiodarone cause thyroid storm?

Amiodarone-induced thyrotoxicosis was the most common cause of thyroid storm (33%), followed by Graves’ disease (26%). Autoimmune thyroiditis, toxic multinodular goiter, and toxic solitary thyroid adenoma were much less frequent causes (10%, 9%, and 6% respectively).

Is it OK to take beta blockers while pregnant?

β-Blockers are the most commonly used class of medication for treating cardiac conditions in pregnant women. Despite the common use of this class of medication, data that support its safety are limited. β-Blockers cross the placenta and potentially can cause physiological changes in the fetus.

Can you take heart medication while pregnant?

Medication you take during pregnancy can affect your baby. Often the benefits outweigh the risks, however. If you need medication to control your heart condition, your health care provider will prescribe the safest medication at the most appropriate dose. Take the medication exactly as prescribed.

Can you take amiodarone with thyroid medication?

Amiodarone may inhibit the peripheral de-iodination of T4 to T3 resulting in a decreased concentration of active hormone, which can cause more overt symptoms in patients with existing hypothyroidism Amiodarone is therefore contraindicated in patients with current or previous thyroid dysfunction.

Can amiodarone cause thyroid disorders?

However, amiodarone is associated with a number of side effects, including thyroid dysfunction (both hypo- and hyperthyroidism), which is due to amiodarone’s high iodine content and its direct toxic effect on the thyroid.

What happens if you suddenly stop taking amiodarone?

Do not stop taking amiodarone without talking to your doctor. You may need to be closely monitored or even hospitalized when you stop taking amiodarone. Amiodarone may remain in your body for some time after you stop taking it, so your doctor will watch you carefully during this time.

Can amiodarone cause thyroid nodules?

There are two distinct forms of amiodarone-induced thyrotoxicosis (AIT): type 1 AIT when the high iodine content of amiodarone precipitates an underlying thyroid disease (Graves’ disease or toxic nodules) and causes hyperthyroidism and type 2 AIT, in which a destructive inflammation caused by amiodarone causes a …

Is amiodarone induced hypothyroidism reversible?

Hypothyroidism in patients with no preexisting thyroid disease often resolves after discontinuation of amiodarone therapy. However, hypothyroidism may persist after discontinuation of treatment in patients with underlying chronic autoimmune thyroiditis and high titers of anti-thyroid peroxidase (anti-TPO) antibodies.

How long does amiodarone induced hyperthyroidism last?

Type 2 AIT is a destructive process of the thyroid gland leading to the release of pre-formed hormone. This thyroiditis is an intrinsic toxic effect of amiodarone. Type 2 AIT usually persists for one to three months until thyroid hormone stores are depleted.

What is the safest beta blocker in pregnancy?

There is a general consensus that labetalol is safer than other β-blockers during pregnancy, and this drug is rapidly becoming the first-line choice in conditions, such as chronic hypertension during pregnancy.

Can amiodarone cause hypothyroidism?

Amiodarone can lead to both hypothyroidism and less commonly hyperthyroidism. Dronedarone is a relatively new anti-arrhythmic drug which was designed to replicate the potency of amiodarone without its associated deleterious side effects.

What is amiodarone used for in pregnancy?

Amiodarone, a benzofuranic derivative, iodine-rich drug, has been used in pregnancy for either maternal or fetal tachyarrhythmias. Amiodarone, its main metabolite (desethylamiodarone) and iodine are transferred, albeit incompletely, through the placenta, resulting in a relevant fetal exposure to the drug and iodine overload.

What is type 1 amiodarone-induced thyroiditis?

Excess iodine-induced thyroid hormone synthesis is known as type I AIT, whereas destruction of thyroid follicles resulting in a thyroiditis with excess release of T3 and T4 is known as type II AIT. Table 2. Pathogenesis and clinical features of amiodarone-induced thyrotoxicosis.

What is the mechanism of action of amiodarone?

Amiodarone inhibits the monodeiodination (5-deiodinase activity) of T4. This leads to a decrease in the generation of T3 from T4, a decrease in the clearance of reverse T3 (rT3) and consequently increased rT3 accumulation [Harjai and Licata, 1996].