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Dronedarone
This factsheet is intended to help those aff ected Dronedarone has been shown to be eff ective in by atrial fi brillation understand the medication reducing the likelihood of recurrence of AF by dronedarone, with a brief introduction to how it around 25% in patients with paroxysmal AF (episodes which come and go on their own) and persistent AF (AF which will not revert to sinus The need for new drugs
Atrial fi brillation (AF) is the most common cardioversion). It has been shown to slow the sustained electrical abnormality of the heart heart rate in AF both at rest and during exercise.
(arrhythmia). Treatment goals focus on stroke prevention and then one of two strategies may be It has been demonstrated to off er clear clinical pursued. A rhythm control strategy seeks to try to benefi ts to patients with a history of atrial Dronedarone - Patient Information
restore the normal electrical activity of the heart fi brillation or atrial fl utter. This was shown in a known as sinus rhythm whilst with a rate control dronedarone reduced the combined risk of being admitted to hospital for a heart related problem combination of anti-arrhythmic drugs (AADs) that try to stabilize the heart electrically, cardioversion As might be anticipated, another study showed and in some cases ablation. One would think that that whilst dronedarone was less eff ective than rhythm control should be superior to rate control amiodarone in preventing AF recurrences, it had but this not been shown to be the case in several significantly fewer side eff ects. In particular it does not increase the risk of related health problems in the thyroid or lungs that can occur One concern has been the potential adverse side eff ects from currently available AADs, such as sotalol and amiodarone, which may be more Which AF patients can be
unpleasant or harmful than any benefit gained in prescribed dronedarone?
using them. So, essentially we need AADs with Dronedarone is indicated for the maintenance better ‘risk profi les’. That is, they, improve a of sinus rhythm after successful cardioversion in patient’s symptoms whilst having fewer adult clinically stable patients with paroxysmal or What is dronedarone?
Which AF patients should not
Dronedarone is a new drug, similar in structure be prescribed dronedarone?
to amiodarone, where chemical changes have Dronedarone should not be given to patients with been made to shorten the time it remains in the AF who have a weakness of the main pumping body and to reduce the risk of thyroid damage. chamber of the heart (left ventricle). This may Its main mechanism of action, like that of be known because of a history of heart failure or amiodarone and sotalol, is to make the heart cells if an echocardiogram that shows left ventricular less excitable and thereby making AF less likely.
What are the relative benefits and
limitations of dronedarone?
permanent AF or any patient who remains consistently in AF for more than six months. Founder & Chief Executive: Trudie Lobban MBE Trustees: Professor A John Camm,
Professor Richard Schilling, Mrs Jayne Mudd Atrial Fibrillation Association Registered Charity No. 1122442 www.aa-international.org
Affiliate
Published January 2009, Reviewed March 2012, Planned Review Date August 2014 If you would like further details on the sources of our information or would like to provide feedback please contact AFA.
Please remember that this publication provides general guidelines only. Individuals should always discuss their condition with their healthcare provider.
Currently there is not enough safety evidence Liver function tests are required regularly and an ECG should be performed at least every six months to confi rm sinus rhythm. Patients should consult their physicians if they develop symptoms What are the side effects and how can they
be managed?
Dronedarone does not aff ect kidney function but Dronedarone is generally well tolerated with no can cause a modest rise in one of its measures increase in serious adverse eff ects when (creatinine) so this should be checked before and after starting dronedarone to give a new baseline.
The most common side eff ects noted are: Dronedarone - Patient Information
Conclusions
diarrhoea, abdominal discomfort, nausea and vomiting. There is an increased incidence of skin Dronedarone is the newest oral AAD and is a rash, slow heart rates and rarely changes in the welcome and very useful addition to the choice of ECG (prolonged QT intervals). Most side eff ects drugs available for the treatment of patients with disappear within the first two weeks of starting the drug, but in some patients, dronedarone will need to be discontinued because of intolerance.
As with all AADs it needs to be used in the right patient as well as monitoring for safety and What other information needs to be
passed on to GPs and patients?
dronedarone is more harmful for patients with heart failure and should not be used here.
Dronedarone should be taken with meals and is given at a dose of 400mg twice daily.
As the options for AF management continue to increase the need for expert specialist advice Dronedarone may raise the blood concentration to help patients to make properly informed of drugs such as verapamil, simvastatin and decisions will become more pressing.
digoxin so this may need to be closely monitored, though this did not cause problems in the major clinical trials. Dronedarone should not be taken together with grapefruit juice or certain herbal products such as St. John’s Wort. Monitoring
All AADs require regular monitoring to ensure they are working and to pick up any possible harmful eff ects. Dronedarone should be started Acknowledgements: Atrial Fibrillation Association would like
to thank all those who helped in the development and review of
and monitored under “specialist” supervision this publication. Particular thanks are given to Dr Khalid Khan, (appropriate hospital consultant or specialist Consultant Cardiologist, and Dr Matt Fay, GP.
Founder & Chief Executive: Trudie Lobban MBE Trustees: Professor A John Camm,
Professor Richard Schilling, Mrs Jayne Mudd Atrial Fibrillation Association Registered Charity No. 1122442 www.aa-international.org
Affiliate
Published January 2009, Reviewed March 2012, Planned Review Date August 2014 If you would like further details on the sources of our information or would like to provide feedback please contact AFA.
Please remember that this publication provides general guidelines only. Individuals should always discuss their condition with their healthcare provider.

Source: http://atrialfibrillationassociation.org/files/file/Publications/130306-jf-FINAL-Dronedarone%20fact%20sheet.pdf