From the Guidelines
Yes, amiodarone is known for causing nausea and vomiting as side effects, as evidenced by the most recent and highest quality study available 1. These gastrointestinal symptoms are relatively common in patients taking this antiarrhythmic medication, particularly during the initial loading phase or when higher doses are used. According to the study published in the European Heart Journal in 2022 1, amiodarone can cause gastrointestinal side effects, including nausea, emesis, and constipation. The study also recommends monitoring the ECG and BP, and suggests that maintenance should be max 200 mg/day to minimize these side effects. Taking amiodarone with food may help reduce these side effects, and if they become severe or persistent, patients should consult their healthcare provider for dosage adjustments or alternative medications 1. Some key points to consider when managing nausea and vomiting in patients taking amiodarone include:
- Assessing for other causes of nausea, such as constipation or CNS pathology
- Considering alternative therapies that target different mechanisms of action, such as serotonin receptor antagonists or corticosteroids
- Educating patients on the potential side effects of amiodarone and the importance of reporting any unusual symptoms. It's worth noting that while other studies, such as those published in 2019 1, discuss the management of nausea and vomiting in different contexts, the most relevant and recent evidence for amiodarone-specific side effects is found in the 2022 study 1.
From the FDA Drug Label
The most common adverse effects leading to discontinuation of amiodarone HCl injection therapy were hypotension (1.6%), asystole/cardiac arrest/EMD (1.2%), VT (1. 1%), and cardiogenic shock (1%). The following table lists the most common (incidence ≥ 2%) treatment-emergent adverse events during amiodarone HCl injection therapy considered at least possibly drug-related... Other treatment-emergent possibly drug-related adverse events reported in less than 2% of patients receiving amiodarone HCl injection in controlled and uncontrolled studies included the following: ... vomiting (sometimes fatal)
- Nausea is not explicitly mentioned in the drug label as an adverse effect.
- Vomiting is mentioned as a possible drug-related adverse event, but with an incidence of less than 2%. Amiodarone is known for causing vomiting, but there is no direct information about nausea.
From the Research
Side Effects of Amiodarone
- Amiodarone has several side effects, including thyroid abnormalities, pulmonary fibrosis, and transaminitis, for which routine monitoring is recommended 2.
- The drug also interacts with several medications, such as warfarin, simvastatin, and atorvastatin, and many HIV antiretroviral medications 2.
- However, nausea and vomiting are not explicitly mentioned as side effects of amiodarone in the provided studies.
Gastrointestinal Side Effects
- None of the studies provided (3,2,4,5,6) mention nausea and vomiting as common side effects of amiodarone.
- The studies focus on the effectiveness of amiodarone in managing atrial fibrillation, its interactions with other medications, and its comparison with other antiarrhythmic drugs.