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September 24, 1982

Adverse Effects of Amiodarone

JAMA. 1982;248(12):1448. doi:10.1001/jama.1982.03330120018007

To the Editor.—  The recent article by Nademanee and Singh (1982;247:217) did not emphasize the significant potential adverse reactions that we have noted in 100 patients receiving a mean dosage of 461 mg/day of amiodarone hydrochloride.Transient ischemic attacks have occurred in four of our patients and cerebral vascular accidents have occurred in three patients after initiation of amiodarone therapy (followup, one to 20 months; mean, 6.6 months). While our patients have a high incidence of vascular disease, only five patients had cerebral vascular accidents before the initiation of amiodarone therapy. We hope that this will not prove to be a long-term sequelae of amiodarone therapy. Weakness, fatigue, a nonproductive cough, and dyspnea have been symptoms that have responded to diuresis. None of our patients required cessation of therapy because of the adult respiratory distress syndrome.We have reported previously1 a grading system for amiodarone keratopathy. However, we neglected to