Unforeseen consequences: Class III antiarrhythmic amiodarone stimulated increase in prostate-specific antigen

Amiodarone is a commonly used antiarrhythmic medication (AAM). While it is approved only for the treatment of life-threatening ventricular arrhythmias,1 it is more broadly used for the treatment of refractory atrial arrhythmias, particularly atrial fibrillation (AF). While effective, amiodarone usage carries with it a multitude of mild to potentially significant or even life-threatening side effects coupled with relatively long half-life, which require frequent multisystem monitoring. Amiodarone has numerous noncardiac adverse effects, including involvement of the lung, eye, skin, thyroid, peripheral nervous system, and liver.1 Thyroid dysfunction has been the most studied endocrine abnormality related to amiodarone. However, other endocrine abnormalities have also been reported with prolonged amiodarone use, including testicular dysfunction and higher serum levels of follicle-stimulating hormone, luteinizing hormone levels,2 and syndrome of inappropriate antidiuretic hormone.3 We present a case of prostate-specific antigen (PSA) elevation following amiodarone initiation with reduction in PSA after cessation of amiodarone. This drug-induced effect has not been reported in the literature.