Nexterone

Generic Name: amiodarone (injection) (A mi OH da rone)
Brand Names: Cordarone I.V., Nexterone

What is Nexterone?

Nexterone (amiodarone) injection is an antiarrhythmic medication that affects the rhythm of heartbeats.

Nexterone 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). Nexterone is used to treat or prevent ventricular tachycardia or ventricular fibrillation.

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

Important information

Nexterone injection is for use only in life-threatening situations. This medication has the potential to cause side effects that could be fatal, and you will receive your injection in a hospital setting. You should not receive this medication 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) or a history of slow heart beats.

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Do not receive Nexterone without telling your doctor if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.

To be sure Nexterone is not causing harmful effects, your blood may need to be tested on a regular basis. Your thyroid and liver function may also need to be tested, and you may need eye exams and chest x-rays. Do not miss any scheduled appointments.

You may continue to have side effects from Nexterone after you stop using it. It could take up to several months for the medicine to completely clear from your body.

What should I discuss with my healthcare provider before using Nexterone?

Nexterone is for use only in life-threatening situations. This medication has the potential to cause side effects that could be fatal, and you will receive your injection in a hospital setting.

You may continue to have side effects from Nexterone after you stop using it. It could take up to several months for the medicine to completely clear from your body.

You should not receive Nexterone injection if you are allergic to amiodarone or iodine, or if you have:

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

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

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before you receive Nexterone, 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; or

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

FDA pregnancy category D. Do not receive Nexterone without telling your doctor 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. Do not use Nexterone while you are breast-feeding a baby.

See also: Pregnancy and breastfeeding warnings (in more detail)

How is Nexterone given?

Nexterone is given as an injection through a needle placed into a vein. This injection is usually given in a hospital setting where your heart can be monitored in case the medication causes serious side effects. Nexterone must be given slowly through an IV infusion, and can take from 48 to 96 hours or longer to complete. Nexterone is often given directly into a large vein in the upper chest (central IV line).

To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Your thyroid and liver function may also need to be tested, and you may need eye exams. Do not miss any scheduled visits to your doctor.

If you need to have any type of surgery (including laser eye surgery), tell the surgeon ahead of time that you are using Nexterone. You may need to stop using the medicine for a short time.

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

After treatment with Nexterone 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?

Use the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and use the medicine at your next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include weakness, slow heart rate, feeling light-headed, or fainting.

What should I avoid?

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 Nexterone and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Amiodarone can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.

Nexterone side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Nexterone: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects, even if they occur up to several months after you stop using Nexterone:

  • a new or a worsening irregular heartbeat pattern;

  • fast, slow, or pounding heartbeats;

  • feeling like you might pass out;

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

  • feeling short 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

  • urinating less than usual or not at all.

Less serious Nexterone 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)

What other drugs will affect Nexterone?

Many drugs can interact with amiodarone. Below is only a partial list. Tell your doctor if you are using:

  • cimetidine (Tagamet);

  • clopidogrel (Plavix);

  • cyclosporine (Gengraf, Neoral, Sandimmune);

  • dextromethorphan (an over-the-counter cough medicine);

  • digoxin (digitalis, Lanoxin, Lanoxicaps);

  • fentanyl (Actiq, Duragesic, Fentora);

  • loratadine (Claritin Alavert);

  • phenytoin (Dilantin);

  • St. John's wort;

  • a blood thinner such as warfarin (Coumadin);

  • a diuretic (water pill);

  • an antibiotic such as azithromycin (Zithromax), ciprofloxacin (Cipro), clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), levofloxacin (Levaquin), rifampin (Rifadin, Rimactane, Rifater, Rifamate), telithromycin (Ketek), and others;

  • an antifungal medication such as itraconazole (Sporanox), or ketoconazole (Extina, Ketozole, Nizoral, Xolegal);

  • an antidepressant such as nefazodone or trazodone (Desyrel);

  • arthritis medication such as diclofenac (Arthrotec, Cataflam, Voltaren, Flector Patch, Solareze) or piroxicam (Feldene);

  • cholesterol-lowering medicines such as cholestyramine (Prevalite, Questran), simvastatin (Zocor), and others;

  • heart or blood pressure medication such as diltiazem (Cardizem, Cartia), nicardipine (Cardene), propranolol (Inderal, InnoPran), verapamil (Calan, Covera, Isoptin, Verelan), and others;

  • heart rhythm medication such as disopyramide (Norpace), flecainide (Tambocor), quinidine (Quin-G), or procainamide (Procan, Pronestyl);

  • insulin or diabetes medication you take by mouth; or

  • medication to treat HIV or AIDS.

This list is not complete and there are many other medicines that can cause serious drug interactions with Nexterone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

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

Where can I get more information?

  • Your doctor or pharmacist can provide more information about Nexterone.
  • Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. 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. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.

Copyright 1996-2014 Cerner Multum, Inc. Version: 2.01. Revision Date: 1/14/2011 11:36:23 AM.

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