Evaluation of the Hemodynamic Effects of Intravenous Amiodarone Formulations During the Maintenance Phase Infusion

Desirae E. Lindquist, Anthony Rowe, Robert Heidel, Travis Fleming, John R. Yates

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3 Citations (Scopus)

Abstract

Background: Two of the excipients in intravenous formulations of amiodarone, polysorbate 80 and benzyl alcohol, have been shown to cause hypotension. A newer formulation of amiodarone, which contains cyclodextrin, is devoid of these excipients. Objective: To evaluate the change in mean arterial pressure when utilizing 2 intravenous amiodarone formulations. Methods: This was a retrospective cohort analysis conducted at an academic medical center. Patients received intravenous amiodarone containing either polysorbate 80/benzyl alcohol (control) or cyclodextrin (cyclodextrin). Patients received these formulations based on a standard institutional protocol of 1 mg/min for 6 hours, followed by 0.5 mg/min for at least 18 hours or until discontinued by the provider. All data were collected from the medical record and included changes in blood pressures, time to lowest systolic blood pressure, concurrent antihypertensive use, and number of patients requiring treatment for hypotension. Results: A total of 160 patients (120 control, 40 cyclodextrin) were included. There was a statistically significant difference in mean arterial pressure between the groups receiving the control formulation of amiodarone compared with the cyclodextrin formulation across the 24-hour maintenance phase infusion (P < 0.001). There was a significant difference between formulations with regard to the change in mean arterial pressure during the 0- to 6-hour and 12- to 18-hour time blocks. There was a statistically significant difference in the number of patients receiving fluid boluses for treatment of hypotension (P = 0.001). Conclusions: The excipients in the formulation of intravenous amiodarone may have a significant role in the hypotensive effects seen throughout the duration the maintenance phase infusion.

Original languageEnglish (US)
Pages (from-to)1317-1321
Number of pages5
JournalAnnals of Pharmacotherapy
Volume49
Issue number12
DOIs
StatePublished - Jan 1 2015

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Amiodarone
Cyclodextrins
Hemodynamics
Maintenance
Hypotension
Excipients
Benzyl Alcohol
Arterial Pressure
Polysorbates
Blood Pressure
Antihypertensive Agents
Medical Records
Cohort Studies
Control Groups
Therapeutics

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

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Evaluation of the Hemodynamic Effects of Intravenous Amiodarone Formulations During the Maintenance Phase Infusion. / Lindquist, Desirae E.; Rowe, Anthony; Heidel, Robert; Fleming, Travis; Yates, John R.

In: Annals of Pharmacotherapy, Vol. 49, No. 12, 01.01.2015, p. 1317-1321.

Research output: Contribution to journalArticle

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