What side effects can dronedarone have?
Below you will find the most important information on possible known side effects of dronedarone.
These side effects do not occur, but you can. Because every person reacts differently to medication. Please also note that the type and frequency of side effects may vary depending on the drug formulation (eg tablet, syringe, ointment).
Very common side effects:
Blood creatinine increase, ECG change (QTc time extended to Bazett).
Common side effects:
heartbeat slowing, diarrhea, nausea and vomiting, abdominal pain, indigestion, rash (also common, patchy, pustular), itching, fatigue, weakness, abnormal levels of liver enzymes.
Occasional side effects:
taste disorder, redness, eczema, photosensitivity of the skin, allergic dermatitis, dermatitis.
Rare side effects:
loss of taste, liver cell damage including liver failure, damage to the nervous system (polyneuropathy).
Seven days after the start of treatment, the doctor should determine the kidney function by measuring the blood creatinine value. Normally dronedarone increases this value without any harmful effect. So it is not necessary to stop hypertension from the drug groups of ACE inhibitors or AT1 receptor antagonists.
If the treatment with the active ingredient causes sensory disturbances, muscle weakness, nutritional disorders and reduced tendon reflexes, these should be examined by the doctor because they may be a side effect of dronedarone.
What interactions does dronedarone show?
Please note that the interactions may vary depending on the drug formulation of a drug (eg tablet, syringe, ointment).
Agents that cause torsades de pointes, a special form of the heart, must not be combined with dronedarone. These include the phenothiazines (group of neuroleptics), the gastric agent cisapride, the calcium channel blocker (not available in Germany) bepridil, tricyclic antidepressants, certain macrolide antibiotics for oral use, the antiallergic terfenadine and class I and III antiarrhythmic drugs. Even with concomitant use of beta-blockers or digoxin (a cardiac glycoside), medical attention is needed.
Dronedarone is broken down by the body when combined with certain active ingredients and therefore acts too strong. This is the case with the fungicides ketoconazole, itraconazole, voriconazole and pozaconazole, the AIDS drug ritonavir, the antibiotics telithromycin and clarithromycin and the antidepressant nefazodone. Calcium channel blockers and the antihypertensives diltiazem and verapamil additionally slow down the heartbeat and should therefore be used with caution by the doctor together with dronedarone. These drugs should initially be used in low doses; A higher dose should only be given after an ECG examination. Grapefruit juice can increase the dronedarone effect three times. Thus, grapefruit juice drinks should be avoided while taking dronedarone.
Other active ingredients accelerate the degradation of dronedarone, which weakens the effect. Therefore, concomitant use of
rifampicin (tuberculosis), antiepileptic drugs such as phenobarbital, carbamazepine and phenytoin or even St. John’s Wort (for depression) is not recommended.
Dronedarone in turn may delay the breakdown of other active ingredients, leading to stronger effect and can cause more side effects. For example, this is the case with
- Statins (against lipid metabolism disorders). Since high statin doses can cause muscle damage, the combination should only be done with medical care. As a patient, you must report muscular symptoms to the doctor immediately.
- Sirolimus and tacrolimus, which are used to suppress rejection after organ transplants. Here, the doctor must adjust their dosages accordingly.
- beta-blockers. Their careful use by the doctor prevents an extreme slowing of the heart activity.
- digoxin. Signs of overdose are manifested in gastrointestinal disorders. In addition, the effects on the heartbeat and the transmission of stimuli from the atrium to the ventricle complement each other. In general, the doctor will reduce the digoxin dose by half.
- the anticoagulant warfarin. It may be easier to bleed.