Amiodarone has several potentially fatal toxicities, the most important of which is pulmonary toxicity (hypersensitivity pneumonitis or interstitial/alveolar pneumonitis). Liver injury is common, but is usually mild and evidenced only by abnormal liver enzymes. Overt liver disease can also occur and has been fatal in a few cases. Amiodarone can exacerbate the arrhythmia by making the arrhythmia less well tolerated or more difficult to reverse. Patients with the indicated arrhythmias must be hospitalized while the loading dose is given, and a response generally requires at least one week, but usually 2 or more .
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Antiarrhythmic, Group III
Chemical Class: Benzofuran
Uses For amiodarone
Amiodarone is used to treat life-threatening heart rhythm problems called ventricular arrhythmias. amiodarone is used in patients who have already been treated with other medicines that did not work.
Amiodarone belongs to the group of medicines known as antiarrhythmics. It works directly on the heart tissue and will slow the nerve impulses in the heart. This helps keep the heart rhythm normal.
amiodarone is available only with your doctor's prescription.
Before Using amiodarone
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For amiodarone, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to amiodarone or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of amiodarone in the pediatric population. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of amiodarone in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving amiodarone.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with Medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking amiodarone, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using amiodarone with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using amiodarone with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Agalsidase Alfa
- Aripiprazole Lauroxil
- Arsenic Trioxide
- Chloral Hydrate
- Dabigatran Etexilate
- Doxorubicin Hydrochloride Liposome
- Ginkgo Biloba
- Morphine Sulfate Liposome
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
- St John's Wort
- Vincristine Sulfate Liposome
Using amiodarone with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using amiodarone with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use amiodarone, or give you special instructions about the use of food, alcohol, or tobacco.
- Grapefruit Juice
Other Medical Problems
The presence of other medical problems may affect the use of amiodarone. Make sure you tell your doctor if you have any other medical problems, especially:
- AV block (type of abnormal heart rhythm), with no pacemaker or
- Bradycardia (slow heartbeat) or
- Cardiogenic shock or
- Sick sinus syndrome (type of abnormal heart rhythm), with no pacemaker—Should not be used in patients with these conditions.
- Eye or vision problems or
- Heart disease (e.g., congestive heart failure) or
- Heart rhythm problems (e.g., QT prolongation) or
- Hypokalemia (low potassium in the blood) or
- Hypomagnesemia (low magnesium in the blood) or
- Hypotension (low blood pressure) or
- Lung disease or other breathing problems (e.g., interstitial pneumonitis) or
- Thyroid problems—Use with caution. May make these conditions worse.
Proper Use of amiodarone
You will receive your first dose of amiodarone in a hospital. Your doctor will watch you closely after you take amiodarone to make sure you do not have any serious side effects.
Take amiodarone exactly as directed by your doctor even though you may feel well. Do not take more medicine than your doctor ordered and do not miss any doses. It may take one or two weeks before your body responds to amiodarone.
amiodarone should come with a medication guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.
You may take amiodarone with or without food, but take amiodarone the same way each time.
The dose of amiodarone will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of amiodarone. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For oral dosage form (tablets):
- For ventricular arrhythmias:
- Adults—At first, 800 to 1600 milligrams (mg) per day taken in divided doses. Your doctor may adjust your dose as needed and tolerated.
- Children—Use and dose must be determined by your doctor.
- For ventricular arrhythmias:
If you miss a dose of amiodarone, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Precautions While Using amiodarone
It is important that your doctor check your progress at regular visits to make sure that amiodarone is working properly. Blood tests may be needed to check for unwanted effects.
Using amiodarone while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
Tell your doctor right away if you are having shortness of breath, chest tightness, wheezing, or any type of breathing problem while using amiodarone.
amiodarone can cause changes in your heart rhythm, such as a condition called QT prolongation. It may cause fainting or serious side effects in some patients. Contact your doctor right away if you have any symptoms of heart rhythm problems, such as fast, pounding, or irregular heartbeats.
Liver problems may occur while you are using amiodarone. Stop using amiodarone and check with your doctor right away if you are having more than one of these symptoms: abdominal pain or tenderness; clay-colored stools; dark urine; decreased appetite; fever; headache; itching; loss of appetite; nausea and vomiting; skin rash; swelling of the feet or lower legs; unusual tiredness or weakness; or yellow eyes or skin.
Check with your doctor immediately if blurred vision, difficulty in reading, or any other change in vision occurs during or after treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).
Check with your doctor right away if you are having burning, numbness, tingling, or painful sensations in the arms, hands, legs, or feet. These could be symptoms of a condition called peripheral neuropathy.
You may need to carry a medical identification card or bracelet showing that you are taking amiodarone. Ask your doctor about this.
Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are taking amiodarone. You may need to stop using amiodarone several days before having surgery or medical tests.
Amiodarone increases the sensitivity of your skin to sunlight; too much sun exposure could cause a serious sunburn. Your skin may continue to be sensitive to sunlight for several months after treatment is stopped. Use a sunscreen when you are outdoors. Wear protective clothing and hats. Avoid sunlamps and tanning beds.
After you have taken amiodarone for a long time, it may cause a blue-gray color to appear on your skin, especially in areas exposed to the sun, such as your face, neck, and arms. This color will usually fade after treatment with amiodarone has ended, although it may take several months. Check with your doctor if this color change occurs.
Grapefruits and grapefruit juice may increase the side effects from amiodarone by increasing the amount of amiodarone in your body. You should not eat grapefruit or drink grapefruit juice while you are using amiodarone.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (e.g., St. John's wort) or vitamin supplements.
amiodarone Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:More common
- dizziness, lightheadedness, or fainting
- fever (slight)
- numbness or tingling in the fingers or toes
- painful breathing
- sensitivity of the skin to sunlight
- shortness of breath
- trembling or shaking of the hands
- trouble with walking
- unusual and uncontrolled movements of the body
- weakness of the arms or legs
- Blue-gray coloring of the skin on the face, neck, and arms
- blurred vision or blue-green halos seen around objects
- dry eyes
- dry, puffy skin
- fast or irregular heartbeat
- pain and swelling in the scrotum
- sensitivity of the eyes to light
- sensitivity to heat
- slow heartbeat
- swelling of the feet or lower legs
- trouble with sleeping
- unusual tiredness
- weight gain or loss
- Skin rash
- yellow eyes or skin
- Abdominal or stomach pain
- back, leg, or stomach pains
- bleeding gums
- blistering, peeling, or loosening of the skin
- blood in the urine
- bloody, black, or tarry stools
- blue lips, fingernails, or skin
- blurred or double vision
- chest pain
- clay-colored stools
- confusion as to time, place, or person
- coughing or spitting up blood
- cracks in the skin
- dark urine
- decreased urine output
- difficult or labored breathing
- difficult urination
- dry cough
- eye pain
- fast heartbeat
- general body swelling
- high fever
- holding false beliefs that cannot be change by fact
- inability to have or keep an erection
- irregular, fast or slow, or shallow breathing
- joint or muscle pain
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- loss in sexual ability, desire, drive, or performance
- loss of heat from the body
- lower back or side pain
- mood or mental change
- muscle cramps or spasms
- muscle pain or stiffness
- muscle twitching
- no breathing
- noisy breathing
- pain in the abdomen, groin, or scrotum
- pain or burning with urination
- pains in the stomach, side, or abdomen, possibly radiating to the back
- pale skin
- pinpoint red spots on the skin
- rapid weight gain
- red skin lesions, often with a purple center
- red, irritated eyes
- red, swollen skin
- scaly skin
- seeing, hearing, or feeling things that are not there
- severe headache
- sore throat
- sores, ulcers, or white spots on the lips or in mouth
- swelling of the face, ankles, or hands
- swelling of the scrotum
- swollen or painful glands
- tightness in the chest
- troubled breathing
- unpleasant breath odor
- unusual bleeding or bruising
- unusual excitement, nervousness, or restlessness
- unusual tiredness or weakness
- vomiting of blood
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- loss of appetite
- nausea and vomiting
- Bitter or metallic taste
- decrease in sexual interest
- decreased sexual ability in males
- flushing of the face
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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