Amiodarone

Generic Name: amiodarone (oral) (A mi OH da rone)
Brand Name: Cordarone, Pacerone

What is amiodarone?

Amiodarone affects the rhythm of your heartbeats. It 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 ventricular tachycardia or ventricular fibrillation.

Amiodarone is for use only in treating life-threatening heart rhythm disorders.

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Important information

Amiodarone is for use only in treating life-threatening heart rhythm disorders.

You should not take this medicine if you are allergic to amiodarone or iodine, or if you have 2nd- or 3rd-degree "AV block" (unless you have a pacemaker), a history of slow heartbeats, or if your heart cannot pump blood properly.

Amiodarone can cause dangerous side effects on your heart, liver, lungs, or thyroid.

Call your doctor or get medical help at once if you have: chest pain, fast or pounding heartbeats, trouble breathing, upper stomach pain, vomiting, dark urine, jaundice (yellowing of the skin or eyes), or if you cough up blood.

Tell your doctor if you have signs of a thyroid problem, such as weight changes, extreme tiredness, dry skin, thinning hair, feeling too hot or too cold, irregular menstrual periods, or swelling in your neck (goiter).

Before taking this medicine

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

Amiodarone can cause dangerous side effects on your heart, liver, lungs, or thyroid.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

Do not use amiodarone if you are pregnant. Taking this medicine during pregnancy can harm the unborn baby or cause thyroid problems or abnormal heartbeats after the baby is born. Amiodarone may also affect the child's growth or development (speech, movement, academic skills) later in life. Use effective birth control to prevent pregnancy during treatment.

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

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How should I take amiodarone?

Take amiodarone exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. You will receive your first few doses in a hospital setting, where your heart rhythm can be monitored.

If you have been taking another heart rhythm medicine, you may need to gradually stop taking it when you start using amiodarone. Follow your doctor's dosing instructions very carefully.

You may take this medicine with or without food, but take it the same way each time.

It may take up to 2 weeks before your heart rhythm improves. Keep using the medicine as directed even if you feel well.

While using amiodarone, you will need frequent medical tests and chest x-rays to check your thyroid, vision, lungs, and liver function. Amiodarone can have long lasting effects on your body. You may need medical tests for several months after you stop using this medicine.

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

Amiodarone can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using this medicine.

Store at room temperature away from moisture, heat, and light.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of amiodarone can be fatal.

Overdose symptoms may include weakness, slow heart rate, feeling light-headed, or loss of consciousness.

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What should I avoid while taking amiodarone?

Grapefruit and grapefruit juice may interact with amiodarone and lead to unwanted side effects. Avoid the use of grapefruit products while taking this medicine.

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.

This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Amiodarone side effects

Get emergency medical help if you have signs of an allergic reaction to amiodarone: 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 after you stop using this medicine. 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:

Common amiodarone side effects may include:

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)

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Amiodarone dosing information

Usual Adult Dose for Arrhythmias:

IV:
Initial dose: 1000 mg over the first 24 hours of therapy, delivered by the following infusion regimen:
-Loading infusions: 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)

Maintenance dose: After the first 24 hours, continue the maintenance infusion rate of 0.5 mg/min; may increase infusion rate to achieve effective arrhythmia suppression.
-Supplemental infusions: 150 mg over 10 minutes (15 mg/min) for breakthrough episodes of ventricular fibrillation (VF) or hemodynamically unstable ventricular tachycardia (VT)

Maximum dose: Initial infusion rate: 30 mg/min

Duration of therapy: Until ventricular arrhythmias stabilize (most patients require 48 to 96 hours); maintenance infusion of up to 0.5 mg/min can be continued for up to 3 weeks.

Comments: Mean daily doses greater than 2100 mg for the first 24 hours were associated with increased risk of hypotension.

Use: Initiation of treatment and prophylaxis of frequently recurring VF and hemodynamically unstable VT in patients refractory to other therapy.


ORAL:
Loading dose: 800 to 1600 mg orally per day for 1 to 3 weeks (occasionally longer) until adequate arrhythmia control is achieved or if side effects become prominent, then switch to adjustment dose
Adjustment dose: 600 to 800 mg orally per day for 1 month, then switch to maintenance dose
Maintenance dose: 400 mg orally per day

Comments:
-May be administered once a day; twice a day dosing is recommended for total daily doses of 1000 mg or more or in patients who experience gastrointestinal tolerance.
-Close monitoring is indicated during the loading phase and surrounding any dose adjustments.
-Maintenance dose should be determined according to antiarrhythmic effect as assessed by patient tolerance as well as symptoms, Holter recordings, and/or programmed electrical stimulation; some patients may require up to 600 mg/day while some can be controlled on lower doses.

Use: Treatment of life-threatening recurrent VF or life-threatening recurrent hemodynamically unstable VT in patients refractory to adequate doses of other antiarrhythmics or those intolerant of alternative agents.

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What other drugs will affect amiodarone?

Amiodarone takes a long time to completely clear from your body. Drug interactions are possible for up to several months after you stop using this medicine. 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.

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

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.

Where can I get more information?


Copyright 1996-2017 Cerner Multum, Inc. Version: 6.05.

Last reviewed: May 26, 2017
Date modified: July 02, 2017