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amiodarone (injection)


Generic Name: amiodarone (injection) (A mi OH da rone)
Brand Name: Nexterone

What is amiodarone injection?

Amiodarone is an antiarrhythmic medication that affects the rhythm of heartbeats.

Amiodarone is used to help keep the heart beating normally in people with life-threatening heart rhythm disorders of the ventricles (the lower chambers of the heart that allow blood to flow out of the heart). Amiodarone is used to treat or prevent ventricular tachycardia or ventricular fibrillation.

Amiodarone injection is for use only in life-threatening situations.

Amiodarone may also be used for purposes not listed in this medication guide.

What is the most important information I should know about amiodarone injection?

Amiodarone injection is for use only in life-threatening situations. You will receive this medicine in a hospital setting.

You should not receive this medicine if you are allergic to amiodarone or iodine, or if you have a serious heart condition such as "AV block" (unless you have a pacemaker), a history of slow heart beats, or if your heart cannot pump blood properly.

What should I discuss with my healthcare provider before using amiodarone injection?

You should not receive this medicine if you are allergic to amiodarone or iodine, or if you have:

  • certain serious heart conditions, especially "AV block" (unless you have a pacemaker);

  • a history of slow heart beats that have caused you to faint; or

  • if your heart cannot pump blood properly.

If possible before you receive amiodarone injection, tell your doctor if you have:

  • breathing problems or lung disorder;

  • liver disease;

  • vision problems;

  • high or low blood pressure;

  • a thyroid disorder;

  • an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);

  • if you have recently been ill with vomiting or diarrhea;

  • if your heart rhythm disorder has recently become worse; or

  • if you have a pacemaker or defibrillator implanted in your chest.

In an emergency situation it may not be possible to tell your caregivers about your health conditions. Make sure any doctor caring for you afterward knows you have received this medicine.

Do not use amiodarone if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.

Amiodarone can pass into breast milk and may harm a nursing baby. You should not breast-feed while receiving this medication.

In an emergency situation, it may not be possible before you are treated with amiodarone injection to tell your caregivers if you are pregnant or breast-feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received this medication.

How is amiodarone injection given?

Amiodarone is injected into a vein through an IV. Amiodarone injection is often given directly into a large vein in the upper chest (central IV line). You will receive this injection in a clinic or hospital setting where your heart can be monitored in case the medicine causes serious side effects.

To be sure amiodarone is not causing harmful effects, your blood will need to be tested often. Your thyroid and liver function may also need to be tested, and you may need eye exams and chest x-rays.

If you need surgery (including laser eye surgery), tell the surgeon ahead of time that you have received amiodarone injection.

This medicine can cause unusual results with certain thyroid tests, even after you stop using it. Tell any doctor who treats you that you have received amiodarone injection.

After treatment with amiodarone injection, your doctor may switch you to a tablet form of this medication. Be sure to read the medication guide or patient instructions for amiodarone oral.

What happens if I miss a dose?

Because you will receive amiodarone in a clinical setting, you are not likely to miss a dose.

What happens if I overdose?

Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid while using amiodarone injection?

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Grapefruit and grapefruit juice may interact with amiodarone and lead to unwanted side effects. Avoid the use of grapefruit products while you are receiving amiodarone.

Avoid exposure to sunlight or tanning beds. Amiodarone can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Amiodarone injection side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Amiodarone takes a long time to completely clear from your body. You may continue to have side effects from amiodarone after you stop using it. It could take up to several months for the medicine to completely clear from your body.

Call your doctor at once if you have any of these side effects, even if they occur up to several months after you stop using amiodarone:

  • a new or a worsening irregular heartbeat pattern;

  • fast, slow, or pounding heartbeats;

  • a light-headed feeling, like you might pass out;

  • wheezing, cough, chest pain, trouble breathing, coughing up blood;

  • shortness of breath (even with mild exertion), swelling, rapid weight gain;

  • blurred vision, vision loss, headache or pain behind your eyes, sometimes with vomiting;

  • swelling, pain, redness, or irritation around your IV needle;

  • weight loss, thinning hair, feeling too hot or too cold, increased sweating, irregular menstrual periods, swelling in your neck (goiter);

  • pain in your upper stomach, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

  • little or no urinating.

Common side effects may include:

  • low fever;

  • slight dizziness; or

  • mild nausea, vomiting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Amiodarone dosing information

Usual Adult Dose for Arrhythmias:

Initial dose (IV): 1000 mg over the first 24 hours of therapy, delivered by the following infusion regimen:
150 mg over the first 10 minutes (15 mg/min),
followed by 360 mg over the next 6 hours (1 mg/min).
Maintenance infusion: 540 mg over the remaining 18 hours (0.5 mg/min).

Initial dose (PO): Loading doses of 800 to 1600 mg/day are required for 1 to 3 weeks (occasionally longer) until initial therapeutic response occurs.
When adequate arrhythmia control is achieved, or if side effects become prominent, the dose should be reduced to 600 to 800 mg/day for one month and then to the maintenance dose, usually 400 mg/day. Some patients may require up to 600 mg/day. Amiodarone may be administered as a single daily dose, or in patients with severe gastrointestinal intolerance, as a twice daily dose.

Usual Pediatric Dose for Supraventricular Tachycardia:

less than 1 month:
Limited data available: oral loading dose: 10 to 20 mg/kg/day orally in 2 divided doses for 7 to 10 days; dosage should then be reduced to 5 to 10 mg/kg/day once daily and continued for 2 to 7 months; this protocol was used in 50 infants (less than 9 months of age) and neonates (as young as 1 day of life); intravenous loading dose: 5 mg/kg given over 60 minutes; Note: Bolus infusion rates should generally not exceed 0.25 mg/kg/minute unless clinically indicated; most studies used bolus infusion time of 60 minutes to avoid hypotension; may repeat initial loading dose to a maximum total initial load: 10 mg/kg; do not exceed total daily bolus of 15 mg/kg/day.

less than 1 year: Initial dose: 600 to 800 mg/1.73 m²/day orally for 4 to 14 days given in 1 to 2 divided doses/day.
Maintenance dose: 200 to 400 mg/1.73 m²/day orally given once a day.

greater than 1 year: Initial dose: 10 to 15 mg/kg/day orally for 4 to 14 days given in 1 to 2 divided doses/day.
Maintenance dose: 5 to 10 mg/kg/day orally given once a day.

What other drugs will affect amiodarone injection?

Many drugs can interact with amiodarone. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with amiodarone, especially:

  • an antibiotic--azithromycin, ciprofloxacin, clarithromycin, erythromycin, levofloxacin, moxifloxacin, pentamidine, and others;

  • an antidepressant--amitriptyline, citalopram, desipramine, doxepin, imipramine, maprotiline, nortriptyline, and others;

  • cancer medicines;

  • a diuretic or "water pill";

  • heart rhythm medication--dofetilide, dronedarone, ibutilide, propafenone, sotalol;

  • HIV or AIDS medication--indinavir, nelfinavir, rilpivirine, ritonavir, saquinavir; OR

  • medicine to treat mental illness--chlorpromazine, fluphenazine, haloperidol, lithium, pimozide, promethazine, thioridazine, ziprasidone, and others.

This list is not complete and many other drugs can interact with amiodarone. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Amiodarone takes a long time to completely clear from your body, and drug interactions are possible for up to several months after you stop using amiodarone injection. Talk to your doctor before taking any medication during this time. Keep track of how long it has been since your last dose of amiodarone.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about amiodarone injection.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 4.05. Revision Date: 2015-01-28, 12:07:11 PM.