Moderate
amiodarone × hydrochlorothiazide
Class III antiarrhythmics (Vaughan Williams)×Thiazide diuretics
Mechanism
Same as the amiodarone/furosemide pair: thiazide-induced hypokalemia and hypomagnesemia raise amiodarone's arrhythmogenic potential. Additionally, both thiazides and amiodarone can cause hyponatremia.
Management
Check potassium, magnesium, and sodium every 1–3 months. Keep potassium > 4.0 mmol/L. Obtain an ECG with QT measurement at baseline and every 6 months.
Sources
- Lexicomp: Lexicomp Drug Interactions (2024)— Wolters Kluwer Clinical Drug Information, Inc. Lexi-Interact Online, 2024
- Pharmaceutical Press: Stockley's Drug Interactions, 12th edition (2024)— Preston CL (ed.). Stockley's Drug Interactions. 12th ed. London: Pharmaceutical Press; 2024