Can patients with an iodine allergy receive amiodarone?
This question was best addressed in a 2012 retrospective medical record review in the journal Pharmacotherapy.
Records of 234 sequential hospitalized patients in 2 academic medical centers with a listed iodine and/or iodinated radiocontrast agent allergy who received oral or intravenous amiodarone were reviewed.
Of the 234 patients, 167 (71%) had a listed previous allergy to iodinated contrast agents, 55 (24%) to iodine, and 12 (5%) to both. Patients received an average inpatient total dose of 2.9 g of amiodarone by either IV or oral routes.
Only 1 of the 234 patients was identified as having a probable allergic reaction to amiodarone according to the Naranjo adverse drug reaction probability scale. One other patient developed a rash that was determined to be caused by an antibiotic. All other patients did not have an identifiable allergic reaction.
The authors concluded:
The incidence of hypersensitivity reaction to amiodarone in hospitalized patients with a listed allergy to iodine or iodinated contrast agents was less than 1%, and all identified reactions were without long-term sequelae. Allergy to iodine and iodinated contrast agents may not be a valid absolute contraindication to amiodarone administration in the inpatient setting.
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