What is amiodarone?

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Generic Name: Amiodarone Brand Name(s): Generics only. No brands available.

Know the basics

What is amiodarone used for?

Amiodarone is used to treat certain types of serious (possibly fatal) irregular heartbeat (such as persistent ventricular fibrillation/tachycardia). It is used to restore normal heart rhythm and maintain a regular, steady heartbeat. Amiodarone is known as an anti-arrhythmic drug. It works by blocking certain electrical signals in the heart that can cause an irregular heartbeat.

How should I take amiodarone?

Take amiodarone by mouth, usually once or twice daily or as directed by your doctor. You may take this medication with or without food, but it is important to choose one way and take this medication the same way with every dose.

Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor instructs you otherwise. Grapefruit can increase the amount of this medication in your bloodstream. Consult your doctor or pharmacist for more details.

The dosage is based on your medical condition and response to treatment. Your doctor may direct you to start this medication at a higher dose and gradually decrease your dose. Follow your doctor’s instructions carefully. Do not stop taking this medication or change the dose without first consulting your doctor.

Tell your doctor if your condition does not improve or if it worsens.

How do I store amiodarone?

Amiodarone is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store amiodarone in the bathroom or the freezer. There may be different brands of amiodarone that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush amiodarone down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using amiodarone?

Before taking amiodarone:

  • Tell your doctor and pharmacist if you are allergic to amiodarone, iodine, or any other medications.
  • Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention these medications listed such as: antidepressants (‘mood elevators’) such as trazodone; anticoagulants (‘blood thinners’) such as warfarin (coumadin); certain cholesterol lowering medications such as atorvastatin (lipitor), cholestyramine (questran), lovastatin (mevacor), and simvastatin (zocor); cimetidine (tagamet); clopidogrel (plavix); cyclosporine (neoral, sandimmune); dextromethorphan (a medication in many cough preparations); fentanyl (actiq, duragesic); hiv protease inhibitors such as indinavir (crixivan), and ritonavir (norvir); loratadine (alavert, claritin); medications for diabetes or seizures; methotrexate (rheumatrex); narcotic medications for pain; and rifampin (rifadin, rimactane). Many other medications may interact with amiodarone, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may have to change the doses of your medications or monitor you carefully for side effects.
  • Tell your doctor what herbal products you are taking, especially st. John’s wort.
  • Tell your doctor if you have or have ever had any conditions, or any problems with your blood pressure.
  • Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. Talk to your doctor if you plan to become pregnant or breast-feed during the first several months after your treatment because amiodarone may remain in your body for some time after you stop taking it.if you become pregnant while taking amiodarone, call your doctor.
  • Talk to your doctor about the risks of taking this medication if you are 65 years of age or older. Older adults should not usually take amiodarone because it is not as safe or effective as other medication(s) that can be used to treat the same condition.
  • If you are having surgery, including dental surgery or laser eye surgery, tell your doctor or dentist that you are taking amiodarone.
  • Plan to avoid unnecessary or prolonged exposure to sunlight or sunlamps and to wear protective clothing, sunglasses, and sunscreen. Amiodarone may make your skin sensitive to sunlight. Exposed skin may turn blue-gray and may not return to normal even after you stop taking this medication.
  • You should know that amiodarone may cause vision problems including permanent blindness. Be sure to have regular eye exams during your treatment and call your doctor if your eyes become sensitive to light or if you see halos, or have blurred vision or any other problems with your vision.
  • You should know that amiodarone may remain in your body for several months after you stop taking it. You may continue to experience side effects of amiodarone during this time. Be sure to tell every health care provider who treats you or prescribes any medication for you during this time that you have recently stopped taking amiodarone.

Is it safe to take amiodarone during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this medication during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication. This medication is pregnancy risk category D according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Know the side effects

What are the side effects of amiodarone?

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.

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 amiodarone:

  • 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;
  • Blurred vision, vision loss, headache or pain behind your eyes, sometimes with vomiting;
  • Feeling short of breath, even with mild exertion, swelling, rapid weight gain;
  • Weight loss, thinning hair, feeling too hot or too cold, increased sweating, irregular menstrual periods, swelling in your neck (goiter);
  • Numbness, burning, pain, or tingling in your hands or feet; or
  • Nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).less serious side effects may include:
  • Feeling dizzy or tired;
  • Nausea, vomiting, stomach pain, constipation, loss of appetite;
  • Sleep problems (insomnia);
  • Weakness, lack of coordination; or
  • Warmth, tingling, or redness under your skin.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with amiodarone?

Amiodarone may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

  • Cimetidine (Tagamet);
  • Clopidogrel (Plavix);
  • Cyclosporine (Gengraf, Neoral, Sandimmune);
  • Dextromethorphan (an over-the-counter cough medicine);
  • Diclofenac (Arthrotec, Cataflam, Voltaren, Flector Patch, Solareze);
  • Digoxin (digitalis, Lanoxin, Lanoxicaps);
  • Loratadine (Claritin Alavert);
  • John’s wort;
  • An antidepressant;
  • A blood thinner such as warfarin (Coumadin);
  • A diuretic (water pill);
  • Insulin or diabetes medication you take by mouth;
  • Narcotic pain medication;
  • Medication to treat HIV or AIDS;
  • 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 (Nizoral);
  • A beta-blocker such as atenolol (Tenormin), bisoprolol (Zebeta, Ziac), metoprolol (Lopressor, Toprol), propranolol (Inderal, innopran), and others;
  • Cholesterol-lowering medicines such as cholestyramine (Prevalite, Questran), atorvastatin (Lipitor), simvastatin (Zocor), lovastatin (Mevacor), pravastatin (Pravachol), or fluvastatin (Lescol);
  • Heart rhythm medication such as disopyramide (Norpace), quinidine (Quinaglute, Quinidex), or procainamide (Procan, Pronestyl);
  • Heart or blood pressure medication such as diltiazem (Cardizem, Dilacor, Tiazac), nifedipine (Procardia, Adalat), verapamil (Calan, Covera, Isoptin, Verelan), and others; or
  • Seizure medication such as carbamazepine (Carbatrol, Tegretol), phenytoin (Dilantin), and others.

Does food or alcohol interact with amiodarone?

Amiodarone may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

  • Grapefruit Juice.

What health conditions may interact with amiodarone?

Amiodarone may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • AV block (type of abnormal heart rhythm), with no pacemaker;
  • Bradycardia (slow heartbeat);
  • Cardiogenic shock;
  • Sick sinus syndrome (type of abnormal heart rhythm), with no pacemaker—Should not be used in patients with these conditions.
  • Eye or vision problems;
  • Heart disease (e.g., congestive heart failure);
  • Heart rhythm problems (e.g., QT prolongation);
  • Hypokalemia (low potassium in the blood);
  • Hypomagnesemia (low magnesium in the blood);
  • Hypotension (low blood pressure);
  • Lung disease or other breathing problems (e.g., interstitial pneumonitis);
  • Thyroid problems—Use with caution. May make these conditions worse.

Understand the dosage

The information provided is not a substitute for medical advice. Always consult your doctor or pharmacist before using this medication.

What is the dose of Amiodarone for an adult?

Usual Adult Dose for Arrhythmias

Initial dose: 1000 intravenous 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: Loading doses of 800 to 1600 mg/day orally 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.

What is the dose of Amiodarone for a child?

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.

How is amiodarone available?

Amiodarone is available in the following dosage forms and strengths:

Tablet, Oral: 200 mg.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

Symptoms of overdose may include:

  • Slow heartbeat;
  • Nausea;
  • Blurred vision;
  • Lightheadedness;
  • Fainting.

What should I do if I miss a dose?

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 take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: May 30, 2016 | Last Modified: January 4, 2017

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