1 Lipoprotein oxidation is crucial in atherogenic processes. Amiodarone is a lipophilic antiarrhythmic/antianginal drug which is able to in¯uence the physicochemical status of biological lipid components. Since oxidation of lipids is a ected by their physicochemical state and amiodarone binds to lipoproteins, we hypothesized that the drug may exert an antioxidant activity on human lipoprotein oxidation. 2 Dose-dependent e ects of therapeutically achievable amiodarone concentrations (1.5, 3, 5, 7 and 10 mM) were studied on copper-catalysed oxidation of the non-HDL fraction in vitro. Amiodarone inhibited oxidation as judged by generation of thiobarbituric acid reactive substances (TBARS), lipid hydroperoxides (LOOH) and¯uorescent products of lipoperoxidation (FPL) as well as from the kinetics of conjugated diene formation. This antioxidant activity was signi®cant at 1.5 mM with total inhibition at 10 mM and an IC 50 of 4 mM. The primary in vivo metabolite of amiodarone, namely desethylamiodarone, also exhibited speci®c antioxidant properties although it was less e ective than amiodarone with an IC 50 of 7 mM. 3 In further in vivo experiments, susceptibility to copper-mediated oxidation of the non-HDL fraction was investigated before and 4 weeks after oral amiodarone administration to humans. Following treatment, signi®cant inhibition of TBARS, LOOH and FPL generation was observed in comparison with baseline levels and a placebo-treated control group, highlighting an e ective antioxidant capacity of amiodarone in vivo. 4 Amiodarone did not change lipoprotein vitamin E and phospholipid content in vivo and did not show scavenging e ects on oxidizing species involved in lipoprotein oxidation, such as peroxyl radicals, nor metal-binding/inactivating properties, suggesting that physicochemical modi®cations of lipoprotein lipids induced by the lipophilic drug may be involved in its antioxidant activity. 5 In conclusion, amiodarone, and its primary metabolite desethylamiodarone, show previously unrecognized antioxidant activity on human lipoprotein oxidation. This e ect is also evident in vivo and at therapeutically achievable drug concentrations. Thus, amiodarone may act as an antioxidant/ antiatherosclerotic agent in humans, although this issue warrants further clinical study.