An antiarrhythmic for atrial fibrillation
Dronedarone
A tablet used to help maintain a normal heart rhythm in atrial fibrillation, with liver and heart monitoring.
What is Dronedarone?
Dronedarone is a medicine used to help keep the heart beating in a normal rhythm in people with atrial fibrillation, a common condition where the heart beats irregularly. It works on the heart's electrical system to steady the rhythm. It is taken by mouth as a tablet. It needs regular liver and heart monitoring, because it can occasionally affect the liver and is not suitable for people with certain types of heart problem, such as some kinds of heart failure. It also interacts with a number of other medicines, so a full medicines list is important.
Education and reference only. This is a plain-language guide to Dronedarone — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Dronedarone is an antiarrhythmic medicine, meaning it helps control the rhythm of the heart. It is used in atrial fibrillation, a condition where the upper chambers of the heart beat in a fast, irregular way. Dronedarone is used to help keep the heart in, or return it to, a normal rhythm in suitable people once their rhythm has been settled. It is taken by mouth as a tablet, with food. It is prescribed and monitored carefully, because it is only suitable for certain people and can affect the liver and heart.
How it works
Dronedarone acts on the electrical signals that control the heartbeat, affecting several of the channels in heart cells that carry these signals. By steadying this electrical activity, it helps the heart maintain a more regular rhythm and reduces the tendency to slip back into atrial fibrillation. Because it influences the heart's electrical system, it can also slow the heart and affect its rhythm in ways that need to be checked, and because it is processed by the liver and interacts with many medicines, it needs careful monitoring and review of everything else you take.
Company & origin
Originated / developed by: Specialist manufacturer.
A medicine used in the UK to help keep the heart in a normal rhythm in people with atrial fibrillation, taken by mouth with regular monitoring.
What it treats
Conditions Dronedarone is used for
Practical use
How to take Dronedarone
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take the tablet by mouth with food, at about the same times each day.
- Avoid grapefruit juice while taking it, as this can raise the level of the medicine in your body.
- Attend your liver blood tests and heart checks, which are done before and during treatment.
- Report symptoms such as tummy pain, yellowing of the skin or eyes, dark urine, breathlessness or unusual tiredness straight away.
- Give your team a full list of your medicines, as dronedarone interacts with many of them.
Weighing it up
Advantages & disadvantages of Dronedarone
Advantages
- Helps keep the heart in a normal rhythm in suitable people with atrial fibrillation.
- Taken by mouth as a tablet rather than needing hospital treatment.
- Offers a rhythm-control option for carefully selected people.
Disadvantages
- Only suitable for certain people, and not for some types of heart failure or permanent atrial fibrillation.
- Can occasionally affect the liver, so regular liver blood tests are needed.
- Interacts with a wide range of other medicines and with grapefruit juice.
Practical use
Good to know
An important point is that dronedarone is only suitable for certain people: it is not used in some types of heart failure or in people whose atrial fibrillation is permanent, because in those situations it can do more harm than good, so your suitability is assessed carefully before it is started. It can occasionally affect the liver, sometimes seriously, so liver blood tests are done before and during treatment, and you should report symptoms such as tummy pain, yellowing of the skin or eyes, dark urine or unusual tiredness straight away. It is taken with food. It interacts with a wide range of other medicines, including some that affect the heart rhythm and certain blood thinners, so a complete medicines list is essential. Grapefruit juice can raise its levels and is best avoided.
Who should not take it / use with caution
- People with certain types of heart failure, or whose atrial fibrillation is permanent, must not take it, as it can be harmful.
- People who have had a serious allergic reaction to dronedarone, or who have had serious liver or lung problems with it, should not take it.
- It is avoided in pregnancy and breastfeeding, and used with care with medicines that affect the heart rhythm, under specialist guidance.
Monitoring
- Liver blood tests before and during treatment, as it can occasionally affect the liver.
- Heart checks, including the heart's rhythm and rate, before and during treatment.
- Watching for breathlessness or a cough, which can rarely signal lung problems, and reviewing other medicines.
Side effects
- Tummy upset such as diarrhoea, nausea or feeling bloated.
- Slowing of the heart, tiredness or changes in the heart's rhythm.
- Less commonly but seriously, liver problems, and rarely lung problems, which need urgent attention.
Key interactions
- It interacts with many medicines, including some for the heart rhythm and certain blood thinners, so a full list is essential.
- Grapefruit juice can raise the level of the medicine and is best avoided.
- Medicines that affect the heart's rhythm or are processed in the same way as dronedarone need careful review.
Available as: Tablets taken by mouth.
Answers
Dronedarone: frequently asked questions
What is dronedarone used for?
It is used to help keep the heart in a normal rhythm in suitable people with atrial fibrillation, a condition where the heart beats irregularly.
Why isn't it suitable for everyone?
It is not used in some types of heart failure or when atrial fibrillation is permanent, because in those situations it can do more harm than good, so suitability is assessed carefully.
Why do I need liver tests?
Dronedarone can occasionally affect the liver, so liver blood tests are done before and during treatment, and you should report symptoms such as yellowing of the skin or dark urine.
Can I drink grapefruit juice?
It is best avoided, as grapefruit juice can raise the level of dronedarone in your body, which can increase side effects.
Why does my team need my full medicines list?
Dronedarone interacts with a wide range of other medicines, including some heart and blood-thinning medicines, so a complete list helps keep treatment safe.
Authoritative sources
- BNF
- NICE CKS
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