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;
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:
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: 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.
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
-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.
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;
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.
More about amiodarone
- Amiodarone injection solution
- Amiodarone Intravenous (Advanced Reading)
- Amiodarone Intravenous, Oral (Advanced Reading)
Related treatment guides
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.
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