12 Amiodarone Side Effects You Should Know About
Key takeaways:
Amiodarone (Pacerone) is a prescription medication used to treat certain types of abnormal heart rhythms.
Common amiodarone side effects include nausea and vomiting, dizziness, and constipation. If they’re bothersome, your healthcare provider may lower your dose. These side effects typically improve within a few weeks after that.
Other amiodarone side effects can be very serious. These include problems with your thyroid, eyes, and skin. Your lungs, liver, and heart can be affected, too.
Some amiodarone side effects can be managed by lowering your dose. But others may require stopping the medication. Just don’t try to do this on your own.
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Amiodarone (Pacerone) is a heart rhythm medication known for causing side effects throughout your body. Blue skin discoloration, sun sensitivity, and thyroid problems are just a few examples. And older adults tend to be at higher risk of experiencing side effects from treatment.
Sometimes, amiodarone side effects can be managed by lowering your dose. But other times, you may need to stop taking it. Your healthcare provider will monitor you during treatment and make these adjustments as needed. Yet, knowing what side effects to look for can help them catch potential problems early.
Below, we discuss 12 amiodarone side effects that you should know about.
1. Nausea and vomiting
Nausea and vomiting can be a side effect of many different medications. But it’s very common with amiodarone. It’s also more likely to happen with higher doses.
Let your healthcare provider know if you’re experiencing nausea or vomiting from amiodarone. They can determine the cause and if treatment is needed. They may also consider reducing your dose. This typically resolves the issue — but don’t try to do this on your own.
Nausea and vomiting can also be a sign of liver damage from amiodarone. More on that later.
2. Dizziness
People commonly report feeling dizzy after taking amiodarone. So, it’s a good idea to see how the medication affects you before driving or operating other heavy machinery.
However, dizziness can also be a sign of bradycardia (low heart rate). This can happen if amiodarone slows your heart down too much. Bradycardia isn’t always concerning. But it can be if you’re experiencing symptoms. In addition to dizziness, this can include chest pain, skipping heartbeats, and shortness of breath.
Dizziness can have many different causes. Talk to your healthcare provider if you're feeling dizzy or lightheaded.
3. Constipation
Constipation is another common amiodarone side effect. You can help prevent constipation by keeping hydrated, eating enough fiber, and exercising.
If dietary and lifestyle changes aren’t enough, your healthcare provider may have you try an over-the-counter (OTC) stool softener or laxative. They may also decide to lower your dose. Similar to nausea, this typically helps lessen constipation.
4. Sun sensitivity
Amiodarone can make you more sensitive to the sun (called photosensitivity). This can increase your risk of skin damage from the sun’s ultraviolet rays.
To help prevent sunburns, be sure to wear sunscreen outdoors. Wide-brimmed hats, long sleeves, and pants can help keep your skin covered. You should also avoid tanning beds.
If you do get a sunburn, check out our other GoodRx Health article with tips and tricks to treat it. But if your skin starts blistering, you may need further medical attention.
5. Tremor
Amiodarone can cause tremors, especially at higher doses. These tremors usually happen during a purposeful movement, like touching your nose. It can also happen during movement against gravity, like holding out your arms. You can develop tremors at any point during amiodarone treatment. Experts don’t know for sure why it happens.
Let your healthcare provider know if you develop tremors while taking amiodarone. If your tremors are caused by amiodarone, they may decide to lower your dose. Tremors should improve within a few weeks of the dose adjustment.
However, tremors can also be a sign of thyroid problems from amiodarone, which we’ll cover later.
6. Movement problems
Besides tremor, amiodarone can cause other movement problems. This can include difficulty walking, lack of coordination, or uncontrolled body movements.
Similar to tremors, these movement problems are more common with higher doses. Your healthcare provider may lower your dose if they develop.
7. Thyroid problems
Amiodarone contains iodine, which can affect your thyroid and thyroid hormones. It can cause either hypothyroidism (low thyroid hormone) or hyperthyroidism (elevated thyroid hormone). Your healthcare provider will monitor your thyroid hormone levels before and during treatment.
Let them know if you notice any symptoms of thyroid problems. Examples of hypothyroidism symptoms include constipation, tiredness, and weight gain. Hyperthyroidism symptoms include tremor, weight loss, and irritability. In rare cases, amiodarone may increase the risk of thyroid cancer.
8. Vision changes
A wide range of eye problems can occur when taking amiodarone. The most common problem is corneal deposits. If they develop, some people experience blurred vision or see halos. The good news is that this condition is usually reversible after stopping amiodarone or lowering the dose.
Optic neuritis is also possible with amiodarone. This is inflammation of the eyes’ nerves that can impair your vision. In rare cases, optic neuritis can lead to permanent blindness.
If you have any changes in your vision, talk to your healthcare provider immediately. They may have you stop taking amiodarone. Don’t attempt to do this on your own. But even if you don’t experience any eye problems, regular eye exams are recommended.
9. Skin reactions
Long-term use of amiodarone can turn your skin a blue-gray color. It’s more likely if you have fair skin or get a lot of sun exposure. So, be sure to protect yourself from the sun and use sunscreen. After stopping amiodarone, the discoloration typically goes away over several months.
Also, you should watch out for rash, blisters, or other skin irritation. In some cases, this can be a sign of a serious skin condition, like Stevens-Johnson syndrome. If you develop flu-like symptoms followed by a rash, get immediate medical attention.
10. Lung problems
Lung problems are one of the most serious amiodarone side effects. Amiodarone can cause damage to your lungs, known as pneumonitis. Your healthcare provider will monitor your lungs before and during treatment for problems.
But if you experience any unusual coughing or difficulty breathing, don’t wait. Let your healthcare provider know if this is happening right away. This can help them catch problems earlier to avoid further damage. They’ll likely have you stop taking amiodarone. You may also need to take a steroid for several months to help lessen the inflammation.
11. Liver problems
Liver problems are a rare, but serious concern with amiodarone. The risk increases the longer you take it. In some cases, liver damage from amiodarone can be life-threatening.
Your healthcare provider will monitor your liver before and during treatment for damage. Let them know right away if your symptoms are accompanied by yellowing of the skin or eyes (jaundice), dark urine, and/or abdominal pain.
If there are signs of damage, they may lower your dose or have you stop taking amiodarone. But don’t attempt to stop taking it on your own.
12. Heart problems
Amiodarone is used to treat abnormal heart rhythms. But in rare cases, it can actually lead to heart problems. As mentioned above, amiodarone can cause bradycardia. And sometimes, it can even cause or worsen abnormal heart rhythms.
The risk of heart problems may be higher in people with electrolyte imbalances (like low potassium levels). Your healthcare provider may check your blood work before starting treatment and correct any imbalances ahead of time.
Combining amiodarone with certain medications can also increase this risk. Examples include fluoroquinolone antibiotics, tricyclic antidepressants, and calcium channel blockers. Provide your current medication list for them to review in advance.
Let your healthcare provider know if you have any new or worsening symptoms when taking amiodarone. If you have chest pain, new or worsening palpitations, or shortness of breath, seek immediate medical attention.
When should I contact my healthcare provider about amiodarone side effects?
If you’re concerned about any amiodarone side effects, contact your healthcare provider. Even if you’re unsure, go ahead and give them a call.
They’ll likely be monitoring you closely during treatment. But you should let them know right away about any changes in your vision, movement problems, or skin reactions. Side effects related to breathing or your heart should also be addressed right away.
The bottom line
Amiodarone can cause many side effects. Most commonly, these include nausea and vomiting, dizziness, and constipation. These tend to improve with a lower dose.
Amiodarone can cause serious side effects throughout your body, including your thyroid, lungs, and heart. Your liver and skin can also be affected. It’s important to be aware of these side effects and contact your healthcare provider if symptoms develop.
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References
Alshehri, M., et al. (2020). Ocular adverse effects of amiodarone: A systematic review of case reports. Optometry and Vision Science.
Biancatelli, R. C., et al. (2019). Adverse reactions of amiodarone. Journal of Geriatric Cardiology.
Bryant Ranch Prepack. (2022). Amiodarone HCL [package insert].
Jaworski, K., et al. (2014). Cutaneous adverse reactions of amiodarone. Medical Science Monitor.
Morgan, J. C., et al. (2017). Insights into pathophysiology from medication-induced tremor. Tremor and Other Hyperkinetic Movements.
National Institute of Neurological Disorders and Stroke. (2022). Tremor fact sheet.
Siddoway, L. A., et al. (2003). Amiodarone: Guidelines for use and monitoring. American Family Physician.
Su, V. Y-F., et al. (2013). Amiodarone and the risk of cancer. Cancer.
Trohman, R. G., et al. (2019). Amiodarone and thyroid physiology, pathophysiology, diagnosis and management. Trends in Cardiovascular Medicine.
Wolkove, N., et al. (2009). Amiodarone pulmonary toxicity. Canadian Respiratory Journal.
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