Does Amiodarone Cause Chronic Liver Disease?

Posted on Sat, 16 Jul 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 16 Jul 2016 Answered on

Sat, 6 Aug 2016 Last reviewed on

Question : I had a stent put in May 24th and was suffering from A Fib prior and was electro conversion back to normal. I was placed on amiodarone to maintain normal rhythm. My liver enzymes went extremely high ALT & AST, 185 and 97 respectfully. I feel certain it was the drug because the occurrence was at the same time and I read that this is a side effect of amiodarone. For some reason I was told to see a gastroenterologist. I do not understand why and why do they not change me to sotalol with fewer side effects but maybe not as efficacious?

Answered by Dr. Ilir Sharka (6 hours later)

Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that it is true that amiodarone may be a cause of liver injury. It can lead to hepatitis and even cirrhosis as an adverse effect.

Elevation of ALT and AST could be related to liver injury as well as other organ tissue injury, as these enzymes are not only present in the liver tissues.

For this reason, the doctor has recommended consulting with a gastroenterologist and performing further tests:

- gama GT
- bilirubine
- total proteines
- ALP
- inflammation tests (PCR, sedimentation rate)
- amylase (for possible pancreatitis)
- an abdominal ultrasound.

Anyway, coming to this point all the potential drugs which can help the progression of liver injury should be stopped.

This is why, I would recommend stopping amiodarone and switching to other anti-arrhythmic drugs such as propaphenone, flecainide or sotalol (in this latter case it is necessary to discuss coreg withdrawal).

Hope to have been helpful!

Kind regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar