Other Brands/Names

Azoran, Cordarone, Cortifib, Kendaron, Lamda, Rexidron, Tiaryt.

How It Works

Amiodarone is an antiarrhythmic drug used to treat heart rhythm disorders. It works by blocking certain electrical signals in the heart that can cause an irregular heartbeat.

Indications

Amiodarone is prescribed for treating and preventing certain types of rhythm disorders, specifically in the ventricles and atria of the heart. It is typically used for serious, life-threatening arrhythmias when other medications are ineffective or intolerable. It is usually administered under the supervision of a cardiologist.

Contraindications

• A history of allergy to amiodarone

• Pregnant or breastfeeding women

• Individuals over 65 years of age

• Patients with:

  • Liver disease

  • Lung disease

  • Thyroid disorders

  • Sinus bradycardia (a slower than normal heart rate)

  • Low blood pressure

Side Effects

Some common side effects of amiodarone include nausea, vomiting, constipation, or tremors (uncontrolled muscle contractions). Serious side effects that require immediate medical attention may include:

• Easy bruising or bleeding

• Impaired coordination

• Uncontrolled movements

• Vision disturbances

• Weakness, numbness, or pain in the legs or arms

• New or worsening heart symptoms (e.g., shortness of breath, decreased blood pressure, slow heart rate)

• Liver problems

• Pleural effusion (fluid buildup in the pleural cavity)

• Severe allergic reactions, including Stevens-Johnson syndrome

Types

Amiodarone is available in the following forms, 200 mg tablets and injectable drugs of 150 mg/3 ml ampules.

Dosage

Ventilated Cardiac Arrhythmias (including supraventricular and ventricular arrhythmias)

Adults:

• Initial dose: 5 mg/kg via infusion over 20-120 minutes. The infusion may be repeated up to 1,200 mg (approximately 15 mg/kg) every 24 hours, with the infusion rate adjusted based on clinical response.

• Emergency cases: 

  • 150-300 mg via slow injection over 3 minutes, may be repeated after 15 minutes if necessary.

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• Oral administration:

  • Initial dose: 200 mg three times daily for 1 week, then reduced to 200 mg twice daily for another week.

  • Monitoring dose: 200 mg daily, adjusted based on patient response.

Elderly:

• Use the minimum dose for both injectable and oral administration.

Safety

Amiodarone can increase sensitivity to sunlight. Avoid unnecessary sun exposure, and wear protective clothing, sunglasses, and sunscreen when outdoors.

Amiodarone can cause vision problems, including permanent blindness. Regular eye exams are recommended during treatment, and you should contact your doctor if you experience any eye or vision issues.

Amiodarone can remain in your system for months even after you stop taking it, and you may continue experiencing side effects during this time. Inform your doctor if you have recently discontinued amiodarone.

Drug Interactions

QT Prolongation

Amiodarone can cause QT prolongation, a heart rhythm disturbance that can lead to a rapid and irregular heartbeat. This term is based on an overview of the heart electrocardiogram (ECG) which shows a QT interval. This may occur when amiodarone is taken with:

• Fluoroquinolone antibiotics

• Antipsychotic medications to treat psychotic symptoms in mental disorders (e.g., chlorpromazine, thioridazine)

• Mood disorder medications (e.g., lithium)

• Tricyclic antidepressants (e.g., doxepin, maprotiline)

Delayed Elimination from the Body

Certain medications can affect the elimination of amiodarone from the body, impacting its effects. These include:

• Azole antifungals (e.g., itraconazole)

• Cimetidine (a stomach acid reducer)

• HIV medications (e.g., cobicistat, saquinavir)

• Rifamycin antibiotics (e.g., rifampin)

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