Amiodarone

Amiodarone is an antiarrhythmic accustomed treat and forestalls cavum arrhythmias. It works by obstruction the electrical signals within the heart which will cause an irregular heartbeat. it’s offered in pill type below the name Pacerone and is additionally offered as a generic.

What is amiodarone?

Amiodarone affects the rhythm of your heartbeats. it’s accustomed facilitate keep the center beating usually in individuals with serious rhythm disorders of the ventricles (the lower chambers of the center that permit blood to effuse of the heart). Amiodarone is employed to treat cavum arrhythmia or fibrillation. Amiodarone is to be used solely in treating serious rhythm disorders. Amiodarone will cause dangerous facet effects on your heart, liver, lungs, or vision. You should not take this medication if you’re allergic to antiarrhythmic drug or iodine, or if you have got Adams-Stokes syndrome, a history of slow heartbeats that have caused you to faint, or if your heart cannot pump blood properly.

Call your doctor or get medical facilitate right away if you have: pain, quick or pounding heartbeats, hassle respiration, vision issues, higher abdomen pain, vomiting, dark urine, jaundice (yellowing of the skin or eyes), or if you cough up blood. Tell your doctor if you have got signs of a thyroid drawback, like weight changes, extreme weariness, dry skin, dilution hair, feeling too hot or too cold, irregular catamenial periods, or swelling in your neck (goiter).

Before taking this medication

You should not use amiodarone if you have:

  1. a serious heart condition called “AV block” (2nd or 3rd degree), unless you have a pacemaker;
  2. a history of slow heartbeats that have caused you to faint; or
  3. if your heart cannot pump blood properly.

Amiodarone can cause dangerous side effects on your heart, liver, lungs, or thyroid. To make sure this medicine is safe for you, tell your doctor if you have ever had:

  1. asthma or another lung disorder
  2. liver disease
  3. a thyroid disorder
  4. vision problems
  5. high or low blood pressure
  6. an electrolyte imbalance (such as low levels of potassium or magnesium in your blood); or
  7. if you have a pacemaker or defibrillator implanted in your chest.

Taking amiodarone during significance may damage an unborn baby, or cause thyroid problems or abnormal pulse in the baby after it is born. Amiodarone may also affect the child’s growth or development (speech, movement, academic skills) later in life. Tell your doctor if you are pregnant or if you become pregnant. You should not breast-feed while taking this medicine, and for scores months after stopping. Amiodarone income a long time to clear from your body. Talk to your doctor approx the best funds to fodder your child during this time.

How should I take amiodarone?

Take amiodarone exactly as prescribed by your doctor. Follow all guidance on your prescription label and read all remedy guides or indoctrination sheets. Your doctor may occasionally innovations your dose. You evidence receive your first few doses in an infirmary setting, where your heart rhythm can be monitored. If you have been conveying another heart meters medicine, you may poverty to gradually stop carrying it when you start using amiodarone. Follow your doctor’s dosing instructions very carefully. You may income the tablets with or without food, but profits it the same medium each time. It may proceeds up to 3 weeks before your bosom rhythm improves. Keep using the remedy as directed even if you emotion well. Amiodarone can have long-lasting effects on your body. You may obligation frequent medical experiment while using this medication and for many months after your conclusion dose.if you obligation handling (including laser eye surgery), tell the surgeon ahead of time that you are using amiodarone. This medication tins affect the conseguenze of certain medical tests. Tell any doctor who treats you that you are using this medicine. Store at room temperature away from moisture, heat, and light.

Amiodarone dosing information

Usual adult dose for:

  1. Arrhythmias

Additional dosage information:

  1. Renal Dose Adjustments
  2. Liver Dose Adjustments
  3. Dose Adjustments
  4. Precautions
  5. Dialysis

Usual adult dose for arrhythmias

IV:

  1. Initial dose: 1000 mg over the first 24 hours of therapy, delivered by the following infusion regimen:
    1. Loading infusions: 150 mg over the first 10 minutes (15 mg/min), followed by 360 mg over the next 6 hours (1 mg/min)
    2. Maintenance infusion: 540 mg over the remaining 18 hours (0.5 mg/min)
  2. Maintenance dose: After the first 24 hours, continue the maintenance infusion rate of 0.5 mg/min; may increase the infusion rate to achieve effective arrhythmia suppression.
    1. Supplemental infusions: 150 mg over 10 minutes (15 mg/min) for breakthrough episodes of ventricular fibrillation (VF) or hemodynamically unstable ventricular tachycardia (VT)
  3. Maximum dose: Initial infusion rate: 30 mg/min
  4. 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.
  5. Comments: Mean daily doses greater than 2100 mg for the first 24 hours were associated with an increased risk of hypotension.
  6. Use: Initiation of treatment and prophylaxis of frequently recurring VF and hemodynamically unstable VT in patients refractory to other therapy.

ORAL:

  1. 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
  2. Adjustment dose: 600 to 800 mg orally per day for 1 month, then switch to a maintenance dose
  3. Maintenance dose: 400 mg orally per day

Comments:

  1. May be administered once a day; twice a day dosing is recommended for total daily doses of 1000 mg or more or in patients who experience gastrointestinal tolerance.
  2. Close monitoring is indicated during the loading phase and surrounding any dose adjustments.
  3. The maintenance dose should be determined according to antiarrhythmic effect as assessed by patient tolerance as well as symptoms, Holter recordings, and/or programmed electrical stimulation; some patients may require up to 600 mg/day while some can be controlled on lower doses.

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.

Renal dose adjustments

  1. No adjustment recommended

Liver dose adjustments

  1. No adjustment recommended
  2. If progressive hepatic injury or hepatomegaly occurs or hepatic enzyme levels increase to greater than 3 times normal (or double in a patient with elevated baseline levels): Consider dose reduction or discontinuation.

Dose adjustments

  1. This drug should be used at the lowest effective dose in order to prevent the occurrence of side effects.
  2. IV to oral transition (infusion duration [assuming 0.5 mg/min infusion]: initial oral daily dose)
    • Less than one week: 800 to 1600 mg
    • One to three weeks: 600 to 800 mg
    • Greater than three weeks: 400 mg
  3. Therapeutic drug range: No well-established relationship exists between drug concentration and therapeutic response; however, concentrations much below 1 mg/L are often ineffective and levels above 2.5 mg/L are usually unnecessary.

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