CHF and arrhythmias:
Indications for: Amiodarone
Documented, life-threatening recurrent ventricular fibrillation or hemodynamically unstable ventricular tachycardia.
Give consistently with regard to meals. Individualize. Loading dose (initiate in hospital with cardiac monitoring): 800–1600mg/day in divided doses with meals for 1–3 weeks. After control achieved, 600–800mg/day for 1 month then reduce to maintenance dose, usually 400mg/day.
Cardiogenic shock. Sick sinus syndrome. 2nd- or 3rd-degree AV block. Bradycardia with syncope unless paced.
Be experienced with the treatment and monitoring of life-threatening arrhythmias before prescribing this medication. Correct potassium, magnesium and calcium deficiencies prior to initiation. Monitor for pulmonary and liver toxicity; reduce dose or discontinue if either occurs. Perform baseline pulmonary function tests at initiation, then every 3–6 months. Do liver function tests regularly. Surgery. Monitor thyroid function and signs of thyrotoxicosis. Assess implantable cardiac devices. Do regular ophthalmic exams. Withdraw cautiously. Elderly. Neonates (teratogenic effects). Pregnancy, nursing mothers: not recommended.
Class III antiarrhythmic.
Interactions may persist months after discontinuing. Symptomatic bradycardia when concomitant with ledipasvir/sofosbuvir or with sofosbuvir plus simeprevir; monitor heart rate when starting antiviral treatment. QTc prolongation with Class I and III antiarrhythmics, lithium, phenothiazines, tricyclics, quinolones, macrolides, azole antifungals, halogenated inhalation anesthetics. Potentiates antiarrhythmics (eg, quinidine, procainamide, flecainide; reduce their doses by ⅓ to ½), cyclosporine, digoxin (reduce digoxin dose by ½ or discontinue), oral anticoagulants (reduce anticoagulant dose by ⅓ to ½ and monitor PT), loratadine, dabigatran, fentanyl, phenytoin, lidocaine, dextromethorphan, statins (limit simvastatin dose to 20mg daily or lovastatin dose to 40mg daily). Potentiated by certain quinolones or macrolides, azole antifungals, protease inhibitors, cimetidine, grapefruit juice. Exacerbation of arrhythmias with antiarrhythmics. Additive bradycardia, sinus arrest, and AV block with β-blockers, digoxin, verapamil, diltiazem, ivabradine, clonidine; monitor heart rate. Antagonized by rifampin, St. John's wort, cholestyramine. May alter results of thyroid function tests. See full labeling.
Nausea, vomiting, constipation, anorexia, CHF, pulmonary inflammation or fibrosis, malaise, fatigue, thyroid disorders, flushing, abnormal taste/smell, edema; post-op adult respiratory distress syndrome, exacerbation of arrhythmias, heart block or failure, sinus bradycardia, hepatotoxicity, corneal deposits, optic neuropathy/neuritis (reevaluate if occurs), photosensitivity, skin pigmentation, peripheral neuropathy.
Formerly known under the brand name Cordarone.