Amiodarone Monitoring — RACP Adult Medicine MCQ

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ModerateClinical PharmacologyAmiodarone MonitoringRACP Adult Medicine

A 55-year-old man is commenced on amiodarone 200 mg daily for atrial fibrillation. What baseline investigations should be performed before starting and what monitoring is required?

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Correct answer: B — TFTs, LFTs, CXR, and PFTs at baseline; TFTs and LFTs 6-monthly

Amiodarone has multiple organ toxicities requiring baseline and ongoing monitoring: thyroid (both hypo- and hyperthyroidism – TFTs at baseline then 6-monthly), hepatic (LFTs at baseline then 6-monthly), pulmonary (CXR and PFTs at baseline then annually – pulmonary fibrosis), ophthalmological (baseline eye exam – corneal microdeposits are universal; optic neuropathy is rare), and dermatological (photosensitivity, blue-grey discolouration). Its extremely long half-life (40–55 days) means toxicity can persist months after cessation.

Reference: AMH – 2025 – Amiodarone; eTG – 2025 – Cardiovascular