Dronedarone
Dronedarone, sold under the brand name Multaq, is a class III antiarrhythmic medication developed by Sanofi-Aventis. It was approved by the FDA on July 2, 2009. Besides being indicated in arrhythmias, it was recommended as an alternative to amiodarone for the treatment of atrial fibrillation and atrial flutter in people whose hearts have either returned to normal rhythm or who undergo drug therapy or electric shock treatment i.e. direct current cardioversion (DCCV) to maintain normal rhythm. It is a class III antiarrhythmic drug. In the United States, the FDA approved label includes a claim for reducing hospitalization, but not for reducing mortality, as a reduction in mortality was not demonstrated in the clinical development program. A trial of the drug in heart failure was stopped as an interim analysis showed a possible increase in heart failure deaths, in patients with moderate to severe CHF.
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Trade names | Multaq |
Other names | SR33589 |
AHFS/Drugs.com | Monograph |
MedlinePlus | a609034 |
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Routes of administration | By mouth |
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Bioavailability | 15% (with a high-fat meal) |
Protein binding | >98% |
Metabolism | Extensive Liver (mainly by CYP3A) |
Elimination half-life | 13–19 hours |
Excretion | Feces (84%), urine (~6%) |
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ECHA InfoCard | 100.109.411 |
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Formula | C31H44N2O5S |
Molar mass | 556.76 g·mol−1 |
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The U.S. label for dronedarone includes a boxed warning, stating that dronedarone is contraindicated in patients with NYHA Class IV heart failure, NYHA Class II and III heart failure with a recent decompensation requiring hospitalization or referral to a specialized heart failure clinic, or with permanent atrial fibrillation." Dronedarone is also associated with rare cases of severe liver damage, including liver failure.