Important side effects of antiarrhythmic drugs
| Mortality post-MI | Exacerbation of sustained VT | Atrial flutter with 1:1 AV conduction | Torsades de pointes | Brady- arrrhythmia | Exacerbation of heart failure | Other clinically important adverse effects | |
| Adenosine | ✔ (transient) | ||||||
| Amiodarone | ↓ | Rare | ✔ | Pulmonary fibrosis Photosensitivity Corneal microdeposits Cirrhosis Neuropathy Hypotension (IV) | |||
| β Blockers | ↓↓ | ✔✔ | ✔ (acute) | Bronchospasm Altered response to hypoglycaemia | |||
| Bretylium | Hypotension | ||||||
| Calcium channel blockers (verapamil, diltiazem) | ↔ | ✔ | ✔ | Constipation (verapamil) | |||
| Digitalis | ↔ | ✔ | Arrhythmias Altered mentation, vision Nausea | ||||
| Disopyramide | ✔ | ✔ | Constipation Urinary retention Glaucoma Dry mouth | ||||
| Dofetilide | ↔ | ✔ | |||||
| Flecainide | ↑↑ | ✔ | ✔ | ✔ | |||
| Ibutilide | ✔ | ||||||
| Lidocaine | Altered mentation Seizures | ||||||
| Mexiletine | ↑ | Nausea Tremor | |||||
| Moricizine | ↑↑ | ||||||
| Procainamide | ↑ | ✔ | Drug induced lupus (arthritis, rash, occasional pericarditis) Nausea Hypotension (IV) Marrow aplasia | ||||
| Propafenone | ✔ | Occasional | ✔ | Bronchospasm (especially in PMs) | |||
| Quinidine | ↑ | ✔ | ✔ | ✔ | ✔ | Diarrhea Nausea | |
| Sotalol | ↔ | ✔ | ✔ | Bronchospasm | |||
| Tocainide | Nausea Marrow aplasia |
PM, poor metabolisers. IV, intravenous.