What Are The Unique Properties of Amiodarone?

Before answering the question, “How does amiodarone affect the liver?” an intelligent pharmacological consumer must first understand the unique properties of this antiarrhythmic drug.

According to Very Well Health, amiodarone is set apart from other heart medicines by the fact that it must build up to a certain level in all the body’s tissues before it can be effective. This stands in contrast to working through bloodstream levels until the drug is metabolized by the body or eliminated.

Because of this need for it to build up to a high degree before reaching any kind of therapeutic level, amiodarone is usually given in high doses—sometimes intravenously within an inpatient setting—initially and then tapered off to an everyday maintenance dose.

Amiodarone can affect the liver much like it can any organ system of the body because of another unique attribute. It isn’t metabolized by the liver, but rather leaves the body only through a slow process of cell death and shedding, which every human experiences. Millions of cells come to the end of their life cycle, are shed, and replaced daily.

Because of this, amiodarone can stay in the body for an inordinate amount of time—weeks as compared to the hours and days of other types of medications. There are two possible implications. One is that the consumer must be on the lookout for potential side effects that can rear their ugly head years after initiating the drug. The second is that stopping the drug if it is affecting an organ system may not give immediate respite.

How Does Amiodarone Affect The Liver?

Amiodarone and other prescription and over-the-counter drugs as well as herbal and vitamin supplements can cause drug-induced liver disease. When the liver functions properly and at its full capacity, it accomplishes multiple tasks.

Among these tasks, according to Medicine Net, are the production and secretion of bile which breaks down dietary fats, the purification of blood by changing damaging chemicals into anatomically harmless ones, the removal of harmful chemicals—usually by this same process—and setting them up for secretion through the renal system or solid waste, and the creation of proteins that allow for proper clotting of the blood and other body processes.

Although there are many ways in which liver toxicity from drugs can show themselves, Amiodarone has been specifically linked to cholestasis. Cholestasis is a health situation in which the secretion and flow of bile has been compromised. Bilirubin and bile acids build up in the body and frequently are experienced as jaundice and itching. Jaundice is noted as a generalized yellowing of the skin.

Are There Other Serious Side Effects of Amiodarone?

Amiodarone, according to Healthline, comes with the most serious warnings available from the U.S. Food and Drug Administration (FDA)—the black box warning. That said, it is still useful and lifesaving in instances of severe heart arrhythmia.

If a consumer chooses to take it, a complete risk-benefit assessment needs to be reviewed with the prescribing physician. The patient should be aware that other side effects such as compromised lung function and loss of visual acuity have been noted in some cases.