Administration advice: The manufacturer product information should be consulted. Amiodarone has serious interactions with at least 131 different drugs. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Conventional IV preparation contains polysorbate 80 and benzyl alcohol, Newer IV formulation (Nexterone) does not contain polysorbate 80 or benzyl alcohol.

Consult WARNINGS section for additional precautions. Indicated only for life-threatening arrhythmias: Indicated only for life-threatening arrhythmias because of risk for substantial toxicity; poses, Difficulty of using amiodarone effectively and safely poses significant risk to patients, Patients must be hospitalized while IV loading dose administered; response generally requires at least 1 week, May present without symptoms as abnormal diffusion capacity in a much higher percentage of patients, Common but usually mild and evidenced only by abnormal liver, Effects are prolonged when they occur because of long drug half-life, See "What Are Side Effects Associated with Using Amiodarone? -Respiratory: History, physical exam, chest X-ray, and pulmonary function tests, including diffusion capacity Select one or more newsletters to continue. IV compatibility: The manufacturer product information should be consulted. -HEPATOTOXICITY: Liver injury is common with this drug, but is usually mild and evidenced only by abnormal liver enzymes. What Are Side Effects Associated with Using Amiodarone? Initiate this drug in a clinical setting where continuous ECGs and cardiac resuscitation are available. Amiodarone is only used after defibrillation (or cardioversion) and epinephrine (first line medication) fail to convert VT/VF. All of these events should be manageable in the proper clinical setting in most cases. In a retrospective survey of 192 patients with ventricular tachyarrhythmias, 84 required dose reduction and 18 required at least temporary discontinuation because of adverse effects, and several series have reported 15% to 20% overall frequencies of discontinuation due to adverse reactions. Amiodarone can be administered by intravenous or intraosseous route. Data sources include IBM Watson Micromedex (updated 1 Oct 2020), Cerner Multum™ (updated 1 Oct 2020), Wolters Kluwer™ (updated 30 Sep 2020) and others.

Copyright © 2020 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment. Available for Android and iOS devices. What Other Drugs Interact with Amiodarone? Initial dose: 1000 mg over the first 24 hours of therapy, delivered by the following infusion regimen: Route. Your doctor may adjust your dose as needed and tolerated. Check with your physician for additional information about side effects.

Adjustment dose: 600 to 800 mg orally per day for 1 month, then switch to maintenance dose. It works by blocking certain electrical signals in the heart that can cause an irregular heartbeat. -FATAL TOXICITY: This drug is intended for use only in patients with the indicated life-threatening arrhythmias because its use is accompanied by substantial toxicity. Amiodarone is known as an anti-arrhythmic drug. 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. 50 mg/mL; 150 mg/100mL (Nexterone) 360 mg/200mL (Nexterone) Conventional IV preparation contains polysorbate 80 … -PROARRHYTHMIC EFFECTS: Like other antiarrhythmics, this drug can exacerbate the arrhythmia, e.g., by making the arrhythmia less well tolerated or more difficult to reverse. Although the frequency of such proarrhythmic events does not appear greater with this drug than with many other agents used in this population, the effects are prolonged when they occur. In a pediatric trial of 61 patients, aged 30 days to 15 years, Injection site reactions were seen in 5 (25%) of the 20 patients receiving amiodarone HCI injection through a, Conventional IV amiodarone contains the preservative benzyl alcohol; there have been reports of fatal “gasping, Nexterone does not contain benzyl alcohol, Recommended to start dosing at the lower end of the dosing, Hypersensitivity: Anaphylactic/anaphylactoid reaction (including. Maximum dose: Initial infusion rate: 30 mg/min ", To be administered only by physicians experienced in treatment of life-threatening arrhythmias, who are thoroughly familiar with risks and benefits of amiodarone therapy, and have, Avoid excessive exposure to sunlight; may cause, Attempts to substitute other antiarrhythmic agents when amiodarone must be stopped is difficult due to the complex pharmacokinetics of the drug, including prolonged duration of action and half-life and difficulties predicting them, which in turn increases risk for drug interactions, Hypothyroidism has been reported in 2 to 10% of patients receiving amiodarone and may be, Bradycardia and atrio-ventricular block reported; treat bradycardia by slowing infusion rate or discontinuing therapy; in some patients, inserting a, Hypotension is the most common adverse reaction; in some cases, hypotension may be refractory and result in a fatal outcome; treat hypotension initially by slowing the infusion; additional standard therapy may include vasopressor drugs, positive, Chronic administration of antiarrhythmic drugs may, Acute-onset (days to weeks) pulmonary injury reported in patients treated with IV amiodarone; findings have included pulmonary infiltrates and masses on X-ray, bronchospasm, wheezing, fever, dyspnea, cough, hemoptysis, and hypoxia; some cases have progressed to respiratory failure or death, Postoperatively, occurrences of adult respiratory distress syndrome reported in patients receiving amiodarone therapy who have undergone either cardiac or non-cardiac, Use caution when administering concomitantly with drugs that prolong QTc interval, Corneal microdeposits appear in majority of adults treated; usually discernible only by slit-lamp examination, but give rise to symptoms such as visual halos or, Peripheral neuropathy reported rarely with chronic administration; may resolve upon discontinuation of therapy, Concomitant use of drugs with depressant effects on, Amiodarone can cause fetal harm when administered to a. Fetal exposure may increase the potential for adverse experiences including cardiac, thyroid, neurodevelopmental, Inform patients of the potential hazard to the.

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. Last updated on Nov 6, 2018. disable JavaScript, also known as "Active Scripting". -Endocrine: Thyroid function tests Reconstitution/preparation techniques: The manufacturer product information should be consulted. 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) 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. 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 Medically reviewed by -Hepatic: Liver function tests Even in patients at high risk of arrhythmic death, in whom the toxicity of this drug is an acceptable risk, this drug poses major management problems that could be life-threatening in a population at risk of sudden death, so that every effort should be made to utilize alternative agents first. settings and refresh the page. See additional information.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.