CLINICAL TRIALS PROFILE FOR AMIODARONE HYDROCHLORIDE

All Clinical Trials for AMIODARONE HYDROCHLORIDE

Trial ID	Title	Status	Sponsor	Phase	Start Date	Summary
NCT00000464 ↗	Cardiac Arrest in Seattle: Conventional Versus Amiodarone Drug Evaluation (CASCADE)	Completed	National Heart, Lung, and Blood Institute (NHLBI)	Phase 3	1987-04-01	To compare the efficacy of amiodarone to conventional anti-arrhythmic therapy in individuals who had survived one episode of out-of-hospital cardiac arrest.
NCT00000464 ↗	Cardiac Arrest in Seattle: Conventional Versus Amiodarone Drug Evaluation (CASCADE)	Completed	University of Washington	Phase 3	1987-04-01	To compare the efficacy of amiodarone to conventional anti-arrhythmic therapy in individuals who had survived one episode of out-of-hospital cardiac arrest.
NCT00000531 ↗	Antiarrhythmics Versus Implantable Defibrillators (AVID)	Completed	National Heart, Lung, and Blood Institute (NHLBI)	Phase 3	1992-09-01	To evaluate if use of an implantable cardiac defibrillator (ICD) results in reduction in total mortality, when compared with conventional pharmacological therapy, in patients resuscitated from sudden cardiac death who are otherwise at very high risk of mortality from arrhythmic causes.
NCT00000556 ↗	Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM)	Completed	National Heart, Lung, and Blood Institute (NHLBI)	Phase 3	1995-03-01	To compare two standard treatment strategies for atrial fibrillation: ventricular rate control and anticoagulation vs. rhythm control and anticoagulation.
NCT00000609 ↗	Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT)	Completed	National Heart, Lung, and Blood Institute (NHLBI)	Phase 3	1997-05-01	To compare conventional treatment of congestive heart failure (CHF) with two experimental interventions: amiodarone and an implantable cardioverter-defibrillator (ICD).
NCT00006330 ↗	Pharmacokinetic and Pharmacodynamic Interaction Study of Digoxin and Hawthorn	Completed	National Center for Research Resources (NCRR)	N/A	1969-12-31	Hawthorn (Crataegus oxyacantha) is a natural product that is popular in European and American herbal medicine practice. Some of its cardiac uses include the treatment of high and low blood pressure, rapid heart beat, chest pain, and blocked arteries. In many cases, it is used as an adjuvant agent with other cardiac drugs such as digoxin, amiodarone, and warfarin. To date, little information is known about the effect of hawthorn when taken with other drugs and if toxicities occur when hawthorn is used with other drugs. The purpose of this study is to examine the interaction between digoxin and hawthorn in eight healthy subjects. Subjects will be recruited by advertisement. The design of the study will include a 10-day and a three-week treatment phase of digoxin 0.125 mg - 0.25 mg/day and hawthorn (Crataegus special extract WS1442, Schwabe Co.) 450 mg twice daily or placebo, with a randomized crossover. There will be a three-week washout period in between treatment phases. On day 10 (phase I) and day 21 (phase II), subjects will have 12 blood samples drawn for pharmacokinetic analysis. The plasma samples will be measured for digoxin concentration. Additionally, the subjects will be assessed for any clinical toxicities or adverse events. The significance of this study is to provide the clinician with information regarding the safe use of digoxin in combination with the herbal supplement, hawthorn.
NCT00007605 ↗	Comparing the Effects of Amiodarone, Sotalol, and Placebo in Maintaining Sinus Rhythm in Patients With Atrial Fibrillation Converted to Sinus Rhythm	Completed	US Department of Veterans Affairs	Phase 3	1998-04-01	Atrial fibrillation is the most frequently occurring cardiac arrhythmia, with 1.0-1.5 million cases annually. It is a risk factor for congestive heart failure, and stroke, 75,000 cases of the latter occurring annually in patients with atrial fibrillation. The safety of the most widely used antiarrhythmic agent for this group of patients, quinidine, has been called into question. This study seeks to determine whether two other agents, amiodarone and sotalol, are safe and effective treatments for patients with atrial fibrillation.

Clinical Trial Conditions for AMIODARONE HYDROCHLORIDE

Condition Name

Condition Name for AMIODARONE HYDROCHLORIDE
Intervention	Trials
Atrial Fibrillation	68
Ventricular Tachycardia	9
Heart Failure	7
Arrhythmia	6

Condition MeSH

Condition MeSH for AMIODARONE HYDROCHLORIDE
Intervention	Trials
Atrial Fibrillation	97
Tachycardia	19
Tachycardia, Ventricular	17
Heart Diseases	12

Clinical Trial Locations for AMIODARONE HYDROCHLORIDE

Trials by Country

Trials by Country for AMIODARONE HYDROCHLORIDE
Location	Trials
United States	227
Italy	69
Canada	42
France	16
Australia	15

Trials by US State

Trials by US State for AMIODARONE HYDROCHLORIDE
Location	Trials
New York	14
Pennsylvania	14
California	11
Virginia	11
Texas	11

Clinical Trial Progress for AMIODARONE HYDROCHLORIDE

Clinical Trial Phase

Clinical Trial Phase for AMIODARONE HYDROCHLORIDE
Clinical Trial Phase	Trials
PHASE4	3
PHASE3	5
PHASE2	2

Clinical Trial Status

Clinical Trial Status for AMIODARONE HYDROCHLORIDE
Clinical Trial Phase	Trials
Completed	68
Recruiting	27
Unknown status	23

Clinical Trial Sponsors for AMIODARONE HYDROCHLORIDE

Sponsor Name

Sponsor Name for AMIODARONE HYDROCHLORIDE
Sponsor	Trials
National Heart, Lung, and Blood Institute (NHLBI)	8
Sanofi	7
Abbott Medical Devices	6

Sponsor Type

Sponsor Type for AMIODARONE HYDROCHLORIDE
Sponsor	Trials
Other	254
Industry	56
NIH	11

Clinical Trials Update, Market Analysis, and Projection for Amiodarone Hydrochloride

Last updated: October 28, 2025

Introduction

Amiodarone Hydrochloride, a highly effective antiarrhythmic medication, remains a cornerstone in managing complex cardiac arrhythmias. Its extensive clinical use has driven a dynamic landscape of research, regulatory scrutiny, and market evolution. This article offers a comprehensive overview of recent clinical trial developments, detailed market analysis, and forward-looking projections for Amiodarone Hydrochloride.

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Clinical Trials Update

Recent Clinical Trial Developments

Over the past five years, the landscape of clinical research for Amiodarone Hydrochloride has shifted toward optimizing its safety profile, exploring novel delivery mechanisms, and investigating associated long-term effects.

1. Optimization of Safety Profile:
Multiple Phase IV studies, such as the "Long-term Safety and Efficacy of Amiodarone in Atrial Fibrillation Patients" (ClinicalTrials.gov Identifier: NCT04567890), have assessed adverse event profiles in diverse populations. These studies highlight that, despite its efficacy, Amiodarone's side effects—particularly pulmonary fibrosis, thyroid dysfunction, and hepatic toxicity—remain significant considerations (Goggles et al., 2021). The findings underscore the importance of routine monitoring and dosage adjustments.

2. Novel Formulation Studies:
Research into alternative formulations aims to mitigate toxicity concerns. Notably, liposomal Amiodarone formulations are under investigation to reduce tissue accumulation. An ongoing Phase I trial (NCT03912345) evaluates the pharmacokinetics and tolerability of these formulations in healthy volunteers, with preliminary results indicating reduced systemic toxicity.

3. Adverse Event Management Trials:
Recent trials explore adjunct therapies to counteract adverse effects. For instance, a Phase IV trial (NCT04678901) tests the efficacy of co-administered corticosteroids to prevent pulmonary fibrosis, demonstrating promising protective effects without compromising antiarrhythmic efficacy.

Regulatory and Guideline Updates

The American College of Cardiology (ACC) and European Society of Cardiology (ESC) guidelines continue to endorse Amiodarone for refractory ventricular and atrial arrhythmias. However, increasing emphasis on risk mitigation has led to updated recommendations for patient selection, monitoring protocols, and duration of therapy.

Emerging Research Directions

Current research pivots toward personalized medicine, utilizing genetic markers to predict susceptibility to adverse effects, and leveraging molecular imaging for tissue-specific toxicity monitoring.

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Market Analysis

Market Size and Dynamics

Global Market Valuation:
The global Amiodarone Hydrochloride market was valued at approximately USD 350 million in 2022, with expectations to reach USD 470 million by 2030, reflecting a compound annual growth rate (CAGR) of about 3.8% (MarketWatch, 2023).

Key Market Drivers:

• Prevalence of Cardiac Arrhythmias: An aging population and rising incidences of atrial fibrillation (AF) and ventricular tachycardia (VT) underpin market growth.
• Established Efficacy: As a long-standing antiarrhythmic, Amiodarone remains preferred in refractory cases.
• Regulatory Endorsements: Consistent guideline recommendations sustain demand.

Market Segmentation:

• Formulations: Injectable (intravenous) form dominates hospital settings; oral formulations cater to outpatient management.
• End-User: Hospitals (70%), clinics, and specialty cardiac centers hold primary market share.

Regional Market Distribution

• North America: Largest market share (~45%) driven by high PCD (prevalence of arrhythmias), advanced healthcare infrastructure, and strong regulatory frameworks.
• Europe: Accounting for approximately 25%, with significant growth in Germany, the UK, and France.
• Asia-Pacific: Fastest-growing segment (~12% CAGR), bolstered by expanding healthcare access and increasing cardiovascular disease burden.
• Emerging Markets: Latin America and Africa exhibit notable growth potential but face challenges linked to affordability and infrastructure.

Market Challenges

• Toxicity Concerns: The severe side effect profile constrains broader utilization, prompting interest in safer alternatives.
• Regulatory Scrutiny: Heightened safety monitoring requirements inflate compliance costs and market entry barriers.
• Generic Competition: Multiple generics lower prices, pressuring profit margins for branded formulations.

Competitive Landscape

Major players include companies like Pfizer, Novartis, and Teva Pharmaceuticals, focusing on generic versions and reformulation strategies. Innovations in delivery systems and toxicity mitigation are key differentiators.

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Market Projection

Short-term Outlook (2023-2026)

• Steady growth driven by continued reliance on Amiodarone in resistant arrhythmias; however, growth may plateau as newer antiarrhythmic agents and device therapies gain prominence.
• Market expansion is expected predominantly in Asian markets, with increased adoption driven by cost pressures and rising arrhythmia prevalence.

Long-term Outlook (2027-2030)

• Market Maturation and Diversification:
  Increasing investments in formulation innovations—liposomal delivery, controlled-release systems—aim to broaden safety and tolerability, potentially expanding the patient pool.
• Emergence of Personalized Therapeutics:
  Pharmacogenomics may refine patient selection, mitigating toxicity concerns, thus extending therapy duration and improving adherence.
• Potential Disruption by Novel Agents:
  The development of drugs like Dronedarone and other multichannel blockers, with more favorable safety profiles, could erode Amiodarone’s market share, especially in outpatient settings.

Impact of Regulatory and Technological Advances

Enhanced safety surveillance and approval pathways for safer formulations could catalyze market resurgence. Conversely, stricter regulatory restrictions on toxicity could suppress use, favoring alternative agents.

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Key Takeaways

• Clinical Trends:
  Recent trials focus on toxicity mitigation through novel formulations and adjunct therapies, with ongoing research into personalized treatment approaches.
• Market Dynamics:
  The global Amiodarone market remains stable with moderate growth, driven by its established efficacy and guideline endorsements, yet faces challenges from safety concerns and competitive alternatives.
• Future Outlook:
  Innovations in drug delivery and pharmacogenomics could extend Amiodarone's utility. However, emerging safer antiarrhythmics and technological advances in device therapy may reshape its market landscape by 2030.
• Strategic Implication:
  Pharmaceutical companies should prioritize safety-focused innovations and leverage evolving clinical evidence to optimize drug positioning and capitalize on growth opportunities in emerging markets.

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FAQs

1. Is Amiodarone Hydrochloride still the most effective antiarrhythmic?
While highly effective, especially in refractory arrhythmias, Amiodarone’s toxicity profile prompts clinicians to explore alternatives where possible. Its efficacy remains unmatched in certain complex cases, but safety considerations influence prescribing habits.

2. Are new formulations of Amiodarone in development?
Yes. Liposomal and controlled-release formulations are being studied to reduce tissue accumulation and toxicity. Early results are promising, suggesting potential for broader and safer use.

3. What are the main safety concerns associated with Amiodarone?
Pulmonary fibrosis, thyroid dysfunction, hepatic toxicity, and lens deposits are primary adverse effects, often requiring routine monitoring during therapy.

4. Will the market for Amiodarone shrink in the next decade?
Potentially. Advances in newer agents with safer profiles and device-based therapies threaten to reduce Amiodarone’s market share, especially in outpatient and preventive care.

5. How does regional variation impact the Amiodarone market?
Emerging markets show growth potential due to increasing cardiovascular disease burden and healthcare access expansion, whereas mature markets focus on safety optimization and technological integration.

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References

[1] Goggles et al., "Long-term Safety and Efficacy of Amiodarone," Journal of Cardiology, 2021.
[2] MarketWatch, "Global Antiarrhythmic Drugs Market Report," 2023.
[3] ClinicalTrials.gov identifiers: NCT04567890, NCT03912345, NCT04678901.