Amiodarone

Brand Names

Cordarone, Nexterone, Pacerone

What is Amiodarone

Amiodarone is a complex antiarrhythmic medication used to treat ventricular arrhythmias and atrial fibrillation. It prevents the recurrence of life-threatening ventricular arrhythmias and produces a modest reduction of sudden deaths in high-risk patients. This drug is more effective than sotalol or propafenone in preventing recurrent atrial fibrillation in patients with rhythm-control strategy. In long-term amiodarone therapy the potential drug toxicity and interactions should be considered. Amiodarone dosage should be kept at the lowest effective level.

Side effects of Amiodarone

The common side effects of Amiodarone include:

• constipation
• loss of appetite
• headache
• decreased sex drive
• difficulty falling asleep or staying asleep
• flushing
• dry eyes
• changes in ability to taste and smell
• changes in amount of saliva

Once you have felt any of these serious side effects of Amiodarone contact your doctor immediately:

• rash
• weight loss or gain
• restlessness
• intolerance to heat or cold
• thinning hair
• excessive sweating
• changes in menstrual cycle
• swelling in the front of the neck (goiter)
• eye pain
• swelling of the hands, feet, ankles, or lower legs
• uncontrollable shaking of a part of the body
• movements that you cannot control
• poor coordination or trouble walking
• numbness or tingling in the hands, legs, and feet
• muscle weakness

Indication

Amiodarone is used to treat different types of serious and sometimes fatal irregular heartbeat (such as persistent ventricular fibrillation/tachycardia). This drug is also 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.

Precautions

• Amiodarone can cause lung damage that can be serious and sometimes life-threatening. If you have or have ever had any type of lung disease or if you have ever developed lung damage or breathing problems while taking this medication, you should inform your doctor. If you notice any of the following symptoms, contact your doctor as soon as possible: fever, shortness of breath, wheezing, other breathing problems, cough, or coughing or spitting up blood.
• Amiodarone can also cause liver damage. If you have or have ever had liver disease, inform your doctor. If you notice any of the following symptoms, contact your doctor as soon as possible: nausea, vomiting, dark colored urine, excessive tiredness, yellowing of the skin or eyes, itching, or pain in the upper right part of the stomach.
• Amiodarone can cause arrhythmia (irregular heart rhythm) to worsen or may cause you to develop new arrhythmias. If you have ever been dizzy or lightheaded or have fainted because your heartbeat was too slow and if you have or have ever had low levels of potassium or magnesium in your blood; heart or thyroid disease; or any problems with your heart rhythm other than the arrhythmia that is being treated inform your doctor. You also need to tell your doctor if you are taking any of the following medications: antifungals such as Diflucan, Nizoral, and Sporanox; Zithromax; beta blockers such as propranolol; calcium channel blockers such as diltiazem and other medications for irregular heartbeat

These are most common precautions of Amiodarone. Discuss other possible precautions with your doctor.

Dosage forms

Dosage Guidelines for Amiodarone (Cordarone)

Indication	Administration route and setting	Dosage
Life-threatening arrhythmia	Intravenous, inpatient treatment	150-mg Intravenous bolus over 10 minutes (if necessary, bolus may be repeated in 10 to 30 minutes); then 1 mg per minute for 6 hours; then 0.5 mg per minute for 18 hours; then reduce Intravenous dosage or convert to oral dosing when possible.(2)
Ventricular arrhythmia	Oral, inpatient treatment	800 to 1,600 mg per day in divided doses until a total of 10 g has been given; then 200 to 400 mg per day(2)
Atrial fibrillation	Oral, inpatient or outpatient treatment	600 to 800 mg per day in divided doses until a total of 10 g has been given (may use higher initial dosage or IV dosing in unstable inpatients); then 200 mg per day(10)