Caution issued about amiodarone and hepatitis C drugs

The Government has released a drug safety alert this week about the use of amiodarone in patients who are also taking hepatitis C drugs.

Research from the Medicines and Healthcare Products Regulatory Agency (MHRA) warns that patients using simeprevir (aka Olysio) and sofobuvir (aka Sovaldi) for hepatitis C should only be administered amiodarone if other antiarrhymics can’t be given, as there is an increased risk of severe bradycardia and heart block when taken together.

Olysio and Sovaldi are new antiviral drugs; when treating patients with both heart rhythm disorders and hepatitis C, the MHRA suggests:

• only starting amiodarone in patients taking hepatitis C drugs when other antiarrhythmics are not tolerated or contraindicated, and monitor closely
• monitoring patients at high risk of bradyarrhythmia continuously for 48-hours in an appropriate clinical setting after starting amiodarone
• monitoring patients who have stopped amiodarone within the last few months and need to start taking any of these antiviral combinations—this is due to the long half-life of amiodarone
• advising patients taking amiodarone with any antiviral hepatitis C combinations to watch out for signs and symptoms of bradycardia and heart block, and to get medical help urgently if they experience any of these symptoms: shortness of breath, light-headedness, palpitations, and/or fainting.

Please remember that this alert is for advice and caution only; every patient is different and like all cases, their history, signs, symptoms and your distance from hospital should all be considered before choosing to administer / not administer drugs.

You can read the full alert on the gov.uk website.

Published 28^th August, 2015