Impact of amiodarone use on metoprolol concentrations, α‐OH‐metoprolol concentrations, metoprolol dosing and heart rate: A cross‐sectional study

Bibliographic Details
Title: Impact of amiodarone use on metoprolol concentrations, α‐OH‐metoprolol concentrations, metoprolol dosing and heart rate: A cross‐sectional study
Authors: Sabrina Robert, Marc‐Olivier Pilon, Essaïd Oussaïd, Maxime Meloche, Grégoire Leclair, Martin Jutras, Marie‐Josée Gaulin, Ian Mongrain, David Busseuil, Jean‐Claude Tardif, Marie‐Pierre Dubé, Simon deDenus
Source: Pharmacology Research & Perspectives, Vol 11, Iss 5, Pp n/a-n/a (2023)
Publisher Information: Wiley, 2023.
Publication Year: 2023
Collection: LCC:Therapeutics. Pharmacology
Subject Terms: amiodarone, cytochrome P‐450 CYP2D6, drug interactions, metoprolol, pharmacogenetics, pharmacokinetics, Therapeutics. Pharmacology, RM1-950
More Details: Abstract Small studies suggest that amiodarone is a weak inhibitor of cytochrome P450 (CYP) 2D6. Inhibition of CYP2D6 leads to increases in concentrations of drugs metabolized by the enzyme, such as metoprolol. Considering that both metoprolol and amiodarone have β‐adrenergic blocking properties and that the modest interaction between the two drugs would result in increased metoprolol concentrations, this could lead to a higher risk of bradycardia and atrioventricular block. The primary objective of this study was to evaluate whether metoprolol plasma concentrations collected at random timepoints from patients enrolled in the Montreal Heart Institute Hospital Cohort could be useful in identifying the modest pharmacokinetic interaction between amiodarone and metoprolol. We performed an analysis of a cross‐sectional study, conducted as part of the Montreal Heart Institute Hospital Cohort. All participants were self‐described “White” adults with metoprolol being a part of their daily pharmacotherapy regimen. Of the 999 patients being treated with metoprolol, 36 were also taking amiodarone. Amiodarone use was associated with higher metoprolol concentrations following adjustment for different covariates (p = .0132). Consistently, the association between amiodarone use and lower heart rate was apparent and significant after adjustment for all covariates under study (p = .0001). Our results highlight that single randomly collected blood samples can be leveraged to detect modest pharmacokinetic interactions.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2052-1707
Relation: https://doaj.org/toc/2052-1707
DOI: 10.1002/prp2.1137
Access URL: https://doaj.org/article/0853f8a5071a463ca8c6f9d55b6c7249
Accession Number: edsdoj.0853f8a5071a463ca8c6f9d55b6c7249
Database: Directory of Open Access Journals
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More Details
ISSN:20521707
DOI:10.1002/prp2.1137
Published in:Pharmacology Research & Perspectives
Language:English