A serious warning was issued today about the possibility that Multaq may cause liver failure. This will certainly cause great concern for those of you taking Multaq, but keep in mind this warning is based on 2 reports of patients that required liver transplants between 4 and 6 months after starting Multaq. Over 100,000 people have taken Multaq since it was approved nearly 2 years ago. But on the other hand, the limited data on Multaq means that the long-term incidence of this problem remains unknown.
Multaq is a heart rhythm medication used to prevent complications from atrial fibrillation or atrial flutter. It is a fairly new alternative to amiodarone. Although it isn't as effective as amiodarone, it doesn't cause as many severe side effects. But many of the side effects of concern with amiodarone occur after many years, and Multaq hasn't been around long enough for us to really know if similar toxicities will occur. Liver toxicity is one of the major amiodarone side effects, and until these reports cam out Multaq was assumed to not cause the same problem.
This has several implications for those of you taking Multaq, and you should discuss these with your doctor. First, you should have your liver function tested periodically, especially in the first 6 months of taking it. You should also be aware of the signs of liver failure: itching, yellow eyes or skin, loss of appetite, dark urine, or light colored-stools. If you experience any of these issues, notify your doctor so he or she can evaluate you. If it is discovered that you have a liver problem, and there isn't another viable explanation as to why, you should no longer take Multaq.
Click "Ask The Medicine Guy" to the right if you have any further questions regarding this matter.
Aaron Emmel, PharmD, BCNSP