Side Effects of Long-Term Amiodarone Therapy in Infants and Children
Amiodarone is a very useful drug in the treatment of many dysrhythmias. In the adult, its side effects are well known—some of which may be serious (pulmonary fibrosis and thyroid dysfunction). For these reasons, amiodarone has been cautiously used in the pediatric age group, particularly in infants. We report our experiences with 26 children treated acutely and/or chronically with this drug. Their mean age at the beginning of therapy was 7 ± 4 years; eight patients (pts) were less than 1 year old (group A) and 18 were more than 1 year old (group B). Nineteen pts had supraventricular dysrhythmias and seven had ventricular dysrhythmias. Amiodarone was acutely employed intravenously (IV) in eight pts, with a bolus of 5 mg/kg over 20 minutes, followed by a dose of 10 mg/kg/day for 2–3 days. We did not observe any complications, such as hypotension or severe bradycardia. In the remaining pts, amiodarone therapy had been started orally, with a loading dose of 10 mg/kg/day for 10 days. After loading 24 pts, therapy was continued orally with the dose of 5–7 mg/kg/day for 5 days every week. In the remaining two pts, therapy was stopped after IV loading because of an ineffective response. The mean follow-up of these 24 children is 17 ± 11 months. Group A: 11–9 months (maximum, 29; minimum, 1); Group B: 19 ± 11 months (maximum, 53; minimum, 1). In all children, we monitored clinical status, thyroid function (T3–T4), and conduction status (24-hour Holter) before therapy after a loading period, and at 1, 3, 6, 9, and 12 months.
KeywordsThyroid Function Pulmonary Fibrosis Thyroid Dysfunction Amiodarone Therapy Severe Bradycardia
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