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arznei-telegramm 2012; 43: 47

 


Polyneuropathy and visual disturbances on dronedarone (MULTAQ): A 50-year-old male taking the amiodarone analogue dronedarone (MULTAQ; a-t 2010; 41: 17-9 and 2011; 42: 65-6) for just under a year because of atrial fibrillation developed polyneuropathy with stocking-like loss of sensibility in the left forefoot and visual problems. The complaints still persisted one year after discontinuation of the medication (NETZWERK Report 16.084). Peripheral sensory neuropathies are described as uncommon adverse effects of amiodarone (CORDAREX, generics) which the patient has not previously taken. These effects usually disappear a few months after discontinuation, but in isolated cases they are not completely reversible. In addition, micro-deposits on the anterior surface of the cornea are very commonly found with amiodarone. These can lead to visual disorders but as a rule they resolve 6 to 12 months after the end of treatment. Optical neuropathy or optical neuritis, which can lead to permanent blindness, are very rare (Sanofi-Aventis: CORDAREX SPC, as at Dec. 2011). In the Summary of Product Characteristics (SPC) of dronedarone, to date there are no references to neuropathy or visual disorders (Sanofi-Aventis: MULTAQ SPC, as at Dec. 2011). In any case, we do not see a positive risk-benefit relationship for the use of the amiodarone variant for rhythm control following successful cardioversion in cases of non-permanent atrial fibrillation, the only licensed indication (a-t 2011; 42: 90).



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