Abstract 12282: Incidence of Amiodarone Hypersensitivity Reaction in Hospitalized Patients with Prior Allergic Reaction to Iodine or Iodinated Contrast
Background: Limited data exist to support or refute the use of amiodarone in patients with a documented iodine allergy. We sought to determine the incidence of a hypersensitivity reaction to amiodarone in hospitalized patients with a documented allergy to iodine or iodinated contrast.
Methods: We retrospectively reviewed the electronic pharmacy databases at two hospitals in Johns Hopkins Health System to identify inpatients hospitalized between January 1, 2006 and December 31, 2010 with a listed prior allergy to iodine and/or iodinated contrast who also received amiodarone during the inpatient stay. Electronic medical records were reviewed to obtain demographic and clinical information and to identify evidence for an allergic reaction to amiodarone. Potential allergic reactions to amiodarone were scored using the Naranjo scale.
Results: A total of 234 patients (mean age 69 +/- 12 yrs, 50% male, 54% with CAD) were identified who met study entry criteria. 167 patients (71%) had listed prior allergy to iodinated contrast, 55 (24%) to iodine, and 12 (5%) to both. Patients received an average inpatient total dose of 2.9 +/- 3.2 grams of either oral (45% of patients), IV (17%), or both oral and IV (38%) amiodarone. The primary indication for amiodarone was VT/VF in 34 (15%) patients and AF in 200 (85%) patients. One out of 234 patients (0.4%) was identified as having a probable allergic reaction to amiodarone (6/10 on Naranjo scale). The patient was a 68 yo woman admitted with pneumonia who had a listed allergy to iodine and received 600 mg of IV amiodarone for AF. She then developed facial flushing and hives which resolved 30 minutes after receiving IV steroids and antihistamines. An additional patient on IV amiodarone developed a transient rash which was later determined to be caused by an antibiotic. All other patients received amiodarone without any identifiable allergic reactions.
Conclusion: The incidence of hypersensitivity reaction to amiodarone in hospitalized patients with listed allergy to iodine or iodinated contrast was less than 1%, and identified reactions were mild and without long-term sequelae. Allergy to iodine and iodinated contrast should not be considered an absolute contraindication to amiodarone administration in the inpatient setting.
- © 2011 by American Heart Association, Inc.