Multaq (Dronedarone)

Multaq Information:

Multaq (Dronedarone) is an antiarrhythmic medication used to treat patients with a history of, or current atrial fibrillation to reduce the incidence of cardiovascular hospitalization due to atrial fibrillation. Multaq is supplied as a 400mg tablet and is taken at the same time each day twice daily with food. Atrial Fibrillation is a cardiac arrhythmia (abnormal heart rhythm) that involves the upper 2 chambers (atria) of the heart. Its names come from the chambers of the heart fibrillating (quivering). Atrial fibrillation results in abnormal electrical impulses being conducted by the heart. Atrial fibrillation (AF) often presents no symptoms and is not in itself generally life-threatening, but it may result in palpitations, fainting, chest pain, or congestive heart failure. Multaq works by maintaining normal sinus rhythm in the heart muscle.

Multaq Side Effects:

Multaq is considered a well tolerated drug. In pooled clinical trials, only 11.8% of patients had to discontinue treatment with Multaq due to adverse effects. The most common adverse effects include diarrhea, nausea, and vomiting. The percentages of the most common adverse effects are listed below.
-Diarrhea (9.0%)
-Nausea (4.9%)
-Abdominal pains (3.5%)
-Vomiting (2.0%)
-Fatigue (4.3%)
-Bradycardia (lowering of heart rate 3.3%)

Multaq Directions:

Many patients may be familiar with Cordarone, before Multaq, Cordarone was the only drug in this class to treat Atrial Fibrillation. Multaq and Cordarone are similar drugs (belonging to the same family or class of medications). However both drugs differ significantly in terms of efficacy and side effect profile. There have been numerous clinical studies performed on the comparison of these 2 drugs. The following is a summary of the findings.
1. Cordarone is more effective in maintaining normal sinus rhythm. Patients are 2 times more likely to remain in normal sinus rhythm with Cordarone than with Multaq.
2. Multaq has much fewer side effects than Cordarone. Cordarone is much more likely to cause serious side effects. Cordarone has much higher potential to cause serious side effects that include thyroid toxicity, pulmonary toxicity, and potential liver damage.
There currently exists great debate about switching from Cordarone to Multaq. However, it is generally agreed amongst health care professionals that Cordarone not be switched to Multaq if the patient is tolerating Cordarone and has not experienced any side effects. Multaq presents an attractive option for any patient who may be at risk of or currently experiencing Cordarone side effects.

Multaq Precautions:

Below is a list of patient groups who should NOT take Multaq or if Multaq is indicated, it should be used with caution in the following patients.
-Pregnant or lactating women or less than 18 years of age. No studies have proven safety in these groups.
-severe congestive heart failure (CHF).
-severe liver damage.
-2nd or 3rd degree AV block or sick sinus syndrome.
-bradycardia <50bpm.
-as listed above, patients taking drugs that may interact with Multaq.

Multaq has the potential to interact with numerous drugs. It is advised that the patient taking Multaq always check with his/her primary care physician and/or pharmacist prior to taking any other medications. The following list indicates some of the drugs that may interact with Multaq.
-Certain antidepressants called Tricyclic antidepressants (ex. Amitryptline)
-Heart medications called Beta Blockers (ex. Metoprotol) and Calcium Channel Blockers (ex. Nifedipine)
-Digoxin
-Antibiotics called Macrolides (ex. Clarithomycin)
-Cholesterol Statin medications (ex. Simvastatin)
-Theophylline
-Warfarin
-Antifungal medications (ex. Itraconazole, ketoconazole)
-Cyclosporine
-Certain anti-epileptic medications (Phenobarbital, Phenytoin)
-grapefruit juice