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Can 'Multaq' taken for parox afib cause or worsen initial infection is this reversible?

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Pulmonologist
Practicing since : 2006
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Been on multaq for parox afib for 8 days. Have one episode of afib per year. Had beginning of uri 5 days before multaq. Was treated with ceftin and prednisone then changed to doxy. No change had ct chest showe one lobule in left lower lung with interstitial pneumonitis. Stopped multaq 36 hrs ago. If multaq is cause or worsened initial infection is this reversible? My fear is that if the pneumonitis is from the multaq its irreversible. Thx
Posted Tue, 14 Jan 2014 in Lung and Chest disorders
 
 
Answered by Dr. Satyadeo Choubey 4 hours later
Brief Answer: Reversibility of toxicity not confirmed yet Detailed Answer: Hi, Thanks for your query. Multaq or dronedarone is recently marketed drug i.e in sept 2012, it was US FDA approved. Lung toxicity profile was established after post marketing approval. And it was emphasized that this can be a cause of drug induced pneumonitis or pulmonary fibrosis. Now coming to your question..... Interstitial pneumonitis can be both drug induced or due to atypical pneumonia caused by organism like mycoplasma, chlamydiae etc that's you have been prescribed doxycycline. Whether multaq increases the incidence of respiratory infection is not clear. If physician feels that multaq is the cause of interstitial pneumonitis, the drug should be immediately discontinued to prevent further toxicity. But whether toxicity is reversible after discontinuation is not established. But with experience from other drugs like methotrexate....lesions are reversible at an early discontinuation....So let's hope better in this regard too......and also if it is due to infection, it is certainly curable with antibiotic you are taking... Best wishes
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Follow-up: Can 'Multaq' taken for parox afib cause or worsen initial infection is this reversible? 19 minutes later
Thx for the answer I'm worried though this may not improve. I was taken off multaq after 8 days of treatment I've known folks on amiodarone that had similar responses. How will I know if it's getting better and how long does it usually take thx
 
 
Answered by Dr. Satyadeo Choubey 8 minutes later
Brief Answer: Can go for repeat scan after a month Detailed Answer: Thanks for follow up. Amiodarone has documented toxicity profile. Its not established for multaq as it has been recently marketed and pulmonary toxicity has been detected in post marketing period. But any pulmonary disease manifests its symptoms and resolution of symptom depicts anatomic resolution..You can follow your lesion on serial chest radiographs. For a simple pneumonia case, radiological resolution takes almost 4 weeks despite clinical resolution in a week. Similarly you may go for a repeat scan after a month or so or repeat just a simple chest xray if the disease was evident on it previously.... Best wishes
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Follow-up: Can 'Multaq' taken for parox afib cause or worsen initial infection is this reversible? 14 minutes later
Thx cxrs were all normal so i guess repeat ct in a month. When symptoms improve is that a trend or can they bounce back and get worse sorry if im asking bad questions its just i have so much to do on a daily basis also my doc has me on budenoside inhaler and says i need to be on it for a month is that ok while im on prednisone wean 15 for week then 10 then 5 also on doxy and ordered labs for multiple bugs thx again
 
 
Answered by Dr. Satyadeo Choubey 9 minutes later
Brief Answer: Can do a ct after a month Detailed Answer: Thanks for follow up. Ok you can repeat CT then. Mostly symptom do not recur unless fibrosis has gone too bad.... prednisolone is sufficient.....But if he has given budesonide inhaler...you may take it...Don't afraid of this as the doses are too low and is delivered at the site itself. only 5-10 % goes to lung rest deposit on posterior pharyngeal wall which comes out as you gargle with water after each shot.... Doxy is good because he is suspecting atypical bacterial pneumonia side by side... If lab result comes out to be suggestive of some particular diagnosis,,,he will modify his treatment... Best wishes
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Follow-up: Can 'Multaq' taken for parox afib cause or worsen initial infection is this reversible? 21 minutes later
Thx he told me by ct no fibrosis at all just the one lobule with interstitial pneumonia/ itis thx again
 
 
Answered by Dr. Satyadeo Choubey 6 minutes later
Brief Answer: its a good news Detailed Answer: Then its again good... Pneumonia is always better than fibrosis. its more reversible than fibrosis...
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