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Amiodarone drug-induced pigmentation
See also in: External and Internal Eye
Other Resources UpToDate PubMed

Amiodarone drug-induced pigmentation

See also in: External and Internal Eye
Contributors: Michael D. Tharp MD, Neil Shear MD
Other Resources UpToDate PubMed


Amiodarone is a class III antiarrhythmic, iodine-rich drug that is commonly used for a wide variety of cardiac arrhythmias. Amiodarone causes a wide range of adverse effects including skin pigmentation, corneal deposits, and complications of the liver and lungs. There can also be alterations of thyroid function.

Skin effects – Blue-gray pigmentation of sun-exposed skin is common. Skin effects also include vasculitis and photosensitivity (30%-50% of patients on amiodarone). Skin pigmentation can develop 6 months to 5 years after beginning therapy.

Ocular effects – Amiodarone will induce mitochondrial deposits in the deep epithelial layer of the cornea. These deposits will form a whorl-like epitheliopathy called "corneal verticillata," or vortex keratopathy. The deposits are barely visible without the aid of a slit lamp and rarely result in any reduction in vision or ocular discomfort. The corneal verticillata are typically found on routine eye exam and are not an indication for discontinuation of the medication. Most patients using amiodarone will develop corneal deposits. Upon discontinuation of the medication, the deposits typically resolve.

Thyroid effects – Adverse events include either hypothyroidism or hyperthyroidism with skin manifestations of myxedema.


T50.995A – Adverse effect of other drugs, medicaments and biological substances, initial encounter

110284009 – Drug-induced pigmentation

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Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Updated:02/20/2018
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Patient Information for Amiodarone drug-induced pigmentation
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Contributors: Medical staff writer


Patients with irregular heart rhythms may be treated with a drug called amiodarone. Among its side effects are sensitivity to sunlight and skin color changes, called hyperpigmentation. This hyperpigmentation looks like blue-gray coloration on sun-exposed skin.

There are other possible side effects of using amiodarone, including corneal deposits in the eyes and thyroid effects.

Who’s At Risk

If you are on amiodarone medication, you may develop skin discoloration within 6 months to 5 years after starting medication.

Signs & Symptoms

Blue-gray coloration appears on your sun-exposed skin. Your eye exam may show deposits on the front of your eye. Your vision will remain normal.

Self-Care Guidelines

To protect yourself from further skin color changes, avoid sun exposure and use sunscreen.

When to Seek Medical Care

If you are taking amiodarone and notice a blue-gray skin coloration, inflamed blood vessels (vasculitis), or other symptoms, you may wish to consult your doctor. Your doctor may consider discontinuing or lowering the dosage on your amiodarone medication.


Once you stop taking amiodarone, the skin coloration usually begins to fade. It may take months to clear.

If you must continue to use amiodarone for a heart condition, your doctor may speak to you about laser treatment, which has been helpful for some individuals.
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Amiodarone drug-induced pigmentation
See also in: External and Internal Eye
A medical illustration showing key findings of Amiodarone drug-induced pigmentation : amiodarone, Corneal opacities, Eye, Forehead, Hyperpigmented patch, Lips, Nose, Vision loss, Sun-exposed distribution, Blurry vision, Cheeks
Clinical image of Amiodarone drug-induced pigmentation - imageId=6646942. Click to open in gallery.  caption: 'Deep blue and somewhat violaceous patches on the dorsal hand, and brown discoloration on the forearm, developing secondary to medication.'
Deep blue and somewhat violaceous patches on the dorsal hand, and brown discoloration on the forearm, developing secondary to medication.
Copyright © 2023 VisualDx®. All rights reserved.