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Amiodarone is available as a 100 mg, 200 mg, and 400 mg oral tablet.

Amiodarone is an antiarrhythmic and is used for the:

• Prevention of recurrent (keeps happening) ventricular arrhythmia
• Treatment of ventricular arrhythmia

Amiodarone is an antiarrhythmic. It works by blocking various receptors and channels in your heart, which play a major part in your heart’s electrical activity. Amiodarone slows down the electrical activity to help your heartbeat stay in a normal ‘sinus’ rhythm.

Amiodarone tablets are usually started in the hospital. The typical ‘loading dose’ is 800 mg to 1600 mg per day until the arrhythmia is controlled, which usually takes 1 to 3 weeks. Then the dose goes down to 600 mg to 800 mg per day for one month, then 400 mg per day long-term.

Amiodarone is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you. You should not use this medication if you have:

• Cardiogenic shock
• Sick sinus syndrome, second- or third-degree atrioventricular block, bradycardia leading to syncope without a functioning pacemaker
• Known hypersensitivity to the drug or to any of its components, including iodine

Common side effects of Amiodarone:

• Nausea
• Vomiting
• Constipation
• Poor appetite
• Abdominal pain
• Skin irritation from sun, or sunburn
• Feeling unwell
• Fatigue
• Tremor or abnormal movement
• Poor coordination
• Difficulty walking
• Headache
• Change in vision
• Abnormal liver tests
• Lung inflammation or scarring
• Flushing
• Dizziness
• Pins and needles sensation in the skin
• Lower sex drive
• Difficulty sleeping

Serious side effects are rare with Amiodarone. Contact your healthcare provider immediately if you experience any of the following.

• New or worsening arrhythmia: Chest discomfort, dizziness, or fainting
• Lung damage: Cough or shortness of breath
• Liver damage: Nausea, vomiting, right-sided stomach pain, fatigue, poor or no appetite, or yellowing of the skin or eyes
• Vision problems

The following medications may interact with Amiodarone:

• QT Prolonging Drugs (class I and III antiarrhythmics, lithium, certain phenothiazines, tricyclic antidepressants, certain fluoroquinolone and macrolide antibiotics, azole antifungals, halogenated inhalation anesthetic agents): Increased risk of Torsade de Pointes. Avoid concomitant use
• Digoxin, beta blockers, verapamil, diltiazem, clonidine, ivabradine: Potentiates the electrophysiologic and hemodynamic effects of Amiodarone, resulting in bradycardia, sinus arrest, and AV block. Monitor heart rate
• CYP450 Inhibitors (grapefruit juice, certain fluoroquinolone and macrolide antibiotics, azole antifungals, cimetidine, certain protease inhibitors): Increased exposure of Amiodarone. Avoid concomitant use
• CYP450 Inducers (St. John’s Wort): Reduced Amiodarone serum levels
• Cyclosporine: Increased plasma levels of cyclosporine have been reported resulting in elevated creatinine, despite reduction of cyclosporine dose. Monitor cyclosporine drug levels and renal function with concomitant use
• Digoxin: Increased digoxin concentration. Reduce digoxin by half or discontinue. If continued, monitor for evidence of toxicity
• HMG-CoA Reductase Inhibitors (simvastatin, lovastatin, atorvastatin): Increased plasma concentration of HMG-CoA reductase inhibitor
• Warfarin: Potentiates anticoagulant response and can result in serious or fatal bleeding. Reduce warfarin dose by one-third to one-half and monitor prothrombin times
• Phenytoin: Increased steady-state levels of phenytoin. Monitor phenytoin levels

Various FDA-approved generic manufacturers

Available data from post-marketing reports and published case series indicate that Amiodarone use in pregnant women may increase the risk for fetal harm. You should talk to your healthcare provider before taking this medication if you are pregnant.

• Pacerone