A 64-year-old man on amiodarone 200 mg daily develops a dry cough and breathlessness on exertion. What is the most appropriate course of action?

• A. Reassure the patient and continue therapy
• B. Refer the patient to the prescriber for urgent review
• C. Stop amiodarone immediately without medical advice
• D. Switch to a different antiarrhythmic agent

Answer: (B)

Amiodarone can cause serious lung toxicity, so new cough and breathlessness in someone taking it require prompt medical evaluation rather than reassurance. When these symptoms appear, urgent review by the prescriber is needed to assess for amiodarone-induced pneumonitis or interstitial lung disease, conduct investigations (such as chest imaging and possibly lung function tests), and decide on the safest management—often stopping or adjusting the drug under supervision and addressing any respiratory compromise. Stopping abruptly without medical advice or switching to another antiarrhythmic without assessment could risk heart rhythm problems or inappropriate management, so the patient should be reviewed urgently rather than left untreated or reassured.