**5. Other side effects of Amiodarone**

Dermatologic, gastrointestinal, neurologic and genitourinary changes are the other side effects of chronic use of Amiodarone. Photosensitivity and less frequently phototoxicity are important dermatological side effects. Photosensitivity is quite common and there is a wide spectrum of skin reactions, ranging from an increased propensity to suntan to intense burning and erythema and swelling of the exposed area [64, 65]. Phototoxicity induces blue-gray skin hyperpigmentation of predominantly sun exposed areas. It develops in <10% of patients, preferentially affecting men. It was mainly observed after an average of 20 months of contin‐ uous Amiodarone treatment and a minimal cumulative dose of 160 g [64, 66]. Histopatholog‐ ically, Amiodarone-induced phototoxicity has been related to lysosomal dermal lipofuscin deposits. The only treatment is reduction or cessation of therapy, upon which skin changes may slowly abate [64, 66]. However, skin discoloration is likely to persist for years. The intensity of these reactions could be alleviated by a reduction in dosage or by application of a protective sunscreen. Patients should be instructed to avoid exposure to the sun or use protective measures during therapy [64–66].

Peripheral neuropathy has been observed in 3–30% of patients on long-term high dosage (generally over 400mg/day) regimen which include tremor, ataxia and sleep disturbances. Histologically, inclusion bodies and segmental demyelination of the nerve fibers have been demonstrated in peripheral nerve fibers. After discontinuation of the medicine, the neurolog‐ ical complication is slowly and incompletely resolved [65, 67].

A significant association was found between the development of epididymitis and high-dose Amiodarone treatment for a long time. Genitourinary effects include sterile epididymitis with pain and swelling in the scrotum [68].
