Q: A few years ago, my husband had what could have been a fatal
incident. Since then he has seen many specialists who discovered he had
an irregular heartbeat, slightly enlarged heart and high blood
pressure. He is on a blood thinner, blood pressure pills and Amiodarone
and Metropolol for the heart.
The problem is that Amiodarone makes his skin sensitive and he should
not be in the sun. For us, who love going to Hawaii, this was a real
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blow. He bought a big hat and stays out of the sun as much as possible.
However, this does not help the skin on his face and neck, which gets
red and pimply. He is self conscious about this condition, but his own
doctor just shrugs it off and prescribed a cream called Aristocort.
A: Amiodarone (Cordarone) is a new drug that is used to control an
irregular heartbeat. It blocks potassium channels and weakly blocks
calcium channels as well as blocking alpha and beta-adrenergic
receptors.
I know this sounds technical, but it helps to explain that it is an
“in-between” drug because it is neither a calcium channel blocker or a
beta-blocker like most of the earlier heart drugs. This makes it
unique. As it is so different, there are no other drugs to replace it
with, which is why your doctor does not get too excited about the side
effect of the rash.
Apart from the skin problem, Amiodarone has some other potentially
serious side effects. The most dangerous one is toxicity to the lungs,
leading to fibrosis, which is stiffening and hardening of the lung
tissue. It can also cause liver disease, dizziness, thyroid problems
and numbness in the hands and feet. It may slow the rate at which
other drugs are
metabolized, as well as raise
cholesterol levels.
After saying all that, you may wonder why anyone would take such a
medication. The clue to the answer is in your letter when you state
that your husband had a “near fatal” incident.
Given the seriousness of your husband’s condition and the fact that he
is obviously enjoying life for the last two years by going to Hawaii, I
think he should put up with the skin condition. The ointment your
doctor prescribed is a cortisone type, and I cannot offer any better
suggestions.
Clare Rowson is a medical doctor with a practice near Belleville, Ont.
Her columns are intended for general information only. Individuals are
encouraged to also seek the advice of their own doctor regarding
medical questions and treatments.
