Incidence of amiodarone hypersensitivity in patients with previous allergy to iodine or iodinated contrast agents

Umashankar Lakshmanadoss, John Lindsley, Daryl Glick, Charles H. Twilley, John J. Lewin, Joseph Marine

Research output: Contribution to journalArticle

Abstract

Study Objective. To determine the incidence and nature of allergic reactions to amiodarone in hospitalized patients with a listed allergy to iodine or iodinated radiocontrast agents. Design. Retrospective medical record review. Setting. Two academic medical centers. Patients. A total of 234 sequential hospitalized patients with a listed iodine and/or iodinated radiocontrast agent allergy who received oral or intravenous amiodarone between January 2006 and December 2010. Measurements and Main Results. Demographic and clinical data, as well as documentation of an allergic reaction to amiodarone, were collected for each patient from electronic medical records. Mean ± SD age was 69 ± 12 years, and 51% were male. 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 ± 3.2 g of either oral (106 patients [45%]), intravenous (39 patients [17%]), or both oral and intravenous (89 patients [38%]) amiodarone. Only 1 (0.4%) of the 234 patients was identified as having a probable allergic reaction to amiodarone (score of 6 on the Naranjo adverse drug reaction probability scale). One additional patient receiving intravenous amiodarone experienced a rash that was determined to be caused by an antibiotic. All other patients received amiodarone without any identifiable allergic reactions. Conclusion. 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.

Original languageEnglish (US)
Pages (from-to)618-622
Number of pages5
JournalPharmacotherapy
Volume32
Issue number7
DOIs
StatePublished - Jul 2012

Fingerprint

Amiodarone
Iodine
Contrast Media
Hypersensitivity
Incidence
Inpatients
Electronic Health Records
Exanthema
Drug-Related Side Effects and Adverse Reactions
Documentation
Medical Records

Keywords

  • Amiodarone hypersensitivity
  • Hospitalized patients
  • Iodine allergy
  • Radiocontrast media allergy

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Incidence of amiodarone hypersensitivity in patients with previous allergy to iodine or iodinated contrast agents. / Lakshmanadoss, Umashankar; Lindsley, John; Glick, Daryl; Twilley, Charles H.; Lewin, John J.; Marine, Joseph.

In: Pharmacotherapy, Vol. 32, No. 7, 07.2012, p. 618-622.

Research output: Contribution to journalArticle

Lakshmanadoss, Umashankar ; Lindsley, John ; Glick, Daryl ; Twilley, Charles H. ; Lewin, John J. ; Marine, Joseph. / Incidence of amiodarone hypersensitivity in patients with previous allergy to iodine or iodinated contrast agents. In: Pharmacotherapy. 2012 ; Vol. 32, No. 7. pp. 618-622.
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abstract = "Study Objective. To determine the incidence and nature of allergic reactions to amiodarone in hospitalized patients with a listed allergy to iodine or iodinated radiocontrast agents. Design. Retrospective medical record review. Setting. Two academic medical centers. Patients. A total of 234 sequential hospitalized patients with a listed iodine and/or iodinated radiocontrast agent allergy who received oral or intravenous amiodarone between January 2006 and December 2010. Measurements and Main Results. Demographic and clinical data, as well as documentation of an allergic reaction to amiodarone, were collected for each patient from electronic medical records. Mean ± SD age was 69 ± 12 years, and 51{\%} were male. 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 ± 3.2 g of either oral (106 patients [45{\%}]), intravenous (39 patients [17{\%}]), or both oral and intravenous (89 patients [38{\%}]) amiodarone. Only 1 (0.4{\%}) of the 234 patients was identified as having a probable allergic reaction to amiodarone (score of 6 on the Naranjo adverse drug reaction probability scale). One additional patient receiving intravenous amiodarone experienced a rash that was determined to be caused by an antibiotic. All other patients received amiodarone without any identifiable allergic reactions. Conclusion. 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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