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Humour based Cardiology- Dronidarone :When Inefficiency becomes an advantage ?

Posted Sep 17 2010 8:38am

Dronedarone is a drug which was developed to replace the very effective  , (but side effect prone ) antiarrhythmic drug Amiodarone.

After years of study ,  Dronedarone has been  approved for use in some* of  our  patients with atrial  fibrillation

* Who are they ?

That is the only thing  , we are  unclear about Dronedarone  ! ! !

The recent studies on Dronedarone DIONYSOS have  clearly  proven it , to be  a  less effective  agent in controlling  AF  , but has a  advantage of fewer adverse effects.

Hence ,  for preventing the potential  side effects  of Amiodarone , let our patients  take an inefficient drug ! This is  how we are inclined  to think ! But the medical industry can not be blamed altogether  , after years of research they develop  a molecule and they would like to  have at least a small pie in the atrial fibrillation market place !

It again proves the centuries old adage,  that all drugs are poisons .If a drug lacks side effects it ceases to have the desired effect also . If you want a drug with zero side effect  a sugar coated placebo  is the best choice !

Is there  really a  role for Dronedarone ?

  • Yes , may be in patients  who have recurrent AF in spite  of stabilising  the underlying conditions that perpetuate AF( Hypertension, CAD, COPD etc)
  • When Amiodarone is contraindicated or withdrawn due to side effects
  • Remember ,  Digoxin, Beta blockers, or even calcium blockers  , can have an  important role in the  chronic management  of AF. But they are unpopular  for many reasons other than academics!

Final message

Dronedarone is power-less antiarrhythmic  drug  ( “Less- powerful ” could be a more  polite  and decent  word !) that has a specific role in the management of AF when  efficient rate or rhythm  control is  deemed unnecessary !

Why don’t  we have study  with  one to one comparison of Digoxin ,Beta blocker and Dronedarone  in the chronic management of   atrial fibrillation !


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