Document Detail


Dronedarone: an alternative to amiodarone?
MedLine Citation:
PMID:  20876046     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To review the safety and efficacy of the newly approved, mixed-activity antiarrhythmic dronedarone (classes I-IV) versus its parent compound comparator, amiodarone (class III, with mixed activity). DATA SOURCES: A MEDLINE/PUBMED (January 1966 to March 2010) and International Pharmaceutical Abstract (January 1975 to March 2010) search of English language papers in addition to a bibliographic search of retrieved papers. STUDY SELECTION: All human studies of dronedarone, alone or in combination with amiodarone, were reviewed. DATA SYNTHESIS: Approved in July 2009, dronedarone is a new antiarrhythmic agent indicated to reduce the risk of hospitalization for cardiac events in patients with paroxysmal or persistent atrial fibrillation or atrial flutter. Dronedarone has been viewed as a potential therapeutic alternative for amiodarone because of a lower risk for pulmonary, thyroid, and dermatologic adverse effects. Compared with amiodarone, dronedarone has poor bioavailability and a shorter terminal disposition half-life, which dictates a twice-daily dosing regimen. Furthermore, dronedarone failed to demonstrate superiority over amiodarone with respect to recurrence of atrial fibrillation in a comparative efficacy analysis. Dronedarone therapy is more costly and increases overall tablet burden. No dosage adjustments are required with dronedarone for renal impairment. Use of dronedarone is contraindicated in the presence of severe hepatic impairment. No serious organ-related toxicities (i.e., thyroid and pulmonary system) have been reported with use of dronedarone. CONCLUSION: Dronedarone as a niche drug may be a reasonable theoretical alternative for patients who cannot tolerate amiodarone or have underlying comorbidities that contraindicate amiodarone use (e.g., pulmonary, thyroid disease). However, dronedarone has not been studied in the vast majority of indications and patient populations in which amiodarone has been studied.
Authors:
Peter J Hughes; Maisha Kelly Freeman; Frances V Cohenour; Emily M Price
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists     Volume:  25     ISSN:  0888-5109     ISO Abbreviation:  Consult Pharm     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-29     Completed Date:  2010-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9013983     Medline TA:  Consult Pharm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  555-69     Citation Subset:  IM    
Affiliation:
Samford University Global Drug Information Service, Birmingham, Alabama 35229, USA. pjhughes@samford.edu
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MeSH Terms
Descriptor/Qualifier:
Amiodarone / adverse effects,  analogs & derivatives*,  pharmacokinetics,  therapeutic use*
Anti-Arrhythmia Agents / therapeutic use*
Atrial Fibrillation / drug therapy
Atrial Flutter / drug therapy
Clinical Trials as Topic
Drug Interactions
Humans
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/dronedarone; 1951-25-3/Amiodarone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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