Which of the following is a side effect that requires counselling when starting amiodarone?

• A. Corneal microdeposits
• B. Pulmonary toxicity
• C. Thyroid dysfunction
• D. Corneal microdeposits, pulmonary toxicity, and thyroid dysfunction

Answer: (D)

Starting amiodarone requires counselling about a range of potential adverse effects because the drug stays in body tissues for a long time and can affect multiple organs. Corneal microdeposits are common with amiodarone and are usually benign, but patients should know that ocular changes can occur and that an eye exam is advisable. The more serious concern is pulmonary toxicity, which can present as a new or worsening cough and shortness of breath and can progress to interstitial pneumonitis or fibrosis; this is why reporting respiratory symptoms promptly is crucial and why clinicians may monitor lung function during therapy. Thyroid dysfunction is also a notable risk due to the drug’s iodine content; both hypothyroidism and hyperthyroidism can occur, so thyroid function testing is typically recommended at baseline and periodically during treatment.

Because counselling should cover all these potential effects to ensure patients recognize symptoms early and seek care when needed, discussing corneal changes, pulmonary toxicity, and thyroid dysfunction together is the most comprehensive and appropriate approach.