Area of interest for monitoring | Monitoring | Possible adverse effect | |
Baseline testing | Follow-up testing | ||
Cardiac | ECG (at baseline and during loading dose) | Yearly After adding medications that interact with amiodarone or prolong the QT interval | QT prolongation; torsades de pointes |
Symptomatic sinoatrial or conduction system impairment | |||
Implantable cardioverter-defibrillators | Defibrillation threshold testing (if clinically indicated) | As needed for signs/symptoms | Increased defibrillation threshold |
Dermatologic | Physical examination | As needed for signs/symptoms | Photosensitivity to UV light |
Blue-gray skin discoloration | |||
Endocrine | TSH (with reflex testing if abnormal) | 3 to 4 months after starting drug, then yearly As needed for signs/symptoms | Hyperthyroidism, hypothyroidism |
Hepatic | AST and ALT | 6 months after starting drug, then yearly | AST or ALT elevation ≥2× upper limit of reference range |
Ophthalmologic | Eye examination | Yearly | Corneal microdeposits |
Optic neuropathy | |||
Pulmonary | Chest radiograph, PFTs* | Yearly for surveillance Along with PFTs (including DLCO) and chest computed tomography for signs/symptoms | Pulmonary toxicity (cough, fever, dyspnea) |
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