Amiodarone, sold under the brand names Cordarone, Nexterone or Pacerone, is used to treat irregular heartbeats (arrhythmias).
Cardiac arrhythmias can occur in conditions such as ventricular arrhythmia, atrial fibrillation, or hypertrophic cardiomyopathy (thickening of the heart walls).
Amiodarone can also be prescribed for children to treat irregular heartbeats in them.
Amiodarone belongs to the group of drugs known as antiarrhythmics. There are four main classes of antiarrhythmic drugs, and amiodarone belongs to class III. It works like this:
- Blocks receptors that use epinephrine
- Slowing or preventing the transfer of sodium from the heart cells
- Decreased electrical activity in the heart
- Increase in activity time for contraction in the heart
Amiodarone was originally approved by the Food and Drug Administration (FDA) under the trademark Pacerone in 1985 and was manufactured by Wyeth Pharmaceuticals (now a division of Pfizer).
Amiodarone can cause a risk of sudden death and potentially dangerous side effects, including:
- Damage to the lungs or their inflammation
- Damage or inflammation of the liver, including those causing abnormal liver function (LFTs)
- Irregular heartbeat or heart rhythm. (Note that drugs taken with arrhythmia can also cause arrhythmia).
You should not take amiodarone if:
- You are allergic to amiodarone or any of the inactive ingredients
- Have a serious anomalous function of the sinus node or 2/3 sinus block
Patients taking amiodarone via injection (intravenously) will need to do this in the hospital.
Talk with your doctor before taking amiodarone, if you are
- Sensitive to sunlight
- Have a bad condition of the thyroid gland
- Have a pacemaker
- Have heart disease, including slow heartbeat, enlarged heart and / or low blood pressure
- Take warfarin (amiodarone may increase the risk of bleeding)
- Have an existing lung disease, such as pulmonary fibrosis or chronic obstructive pulmonary disease (COPD)
Pregnancy and amiodarone
Amiodarone should be taken only in situations where there are no other options available, because the drug can harm the fetus.
Regardless, you should tell your doctor if you are pregnant or can become pregnant before taking this medication.
Amiodarone is not recommended for breast-feeding women, so be sure to tell your doctor if you are breastfeeding or plan to breast-feed.
Side Effects of Amiodarone
You should tell your doctor if any of the following side effects become serious or do not go away:
- Low blood pressure
- Dizziness or headache
- Uncertain walking
- Memory loss
- uncontrolled movements
- Fatigue and sleep problems
- Sensitivity to the sun
- Low thyroid hormone levels
- Elevated cholesterol levels, including triglycerides and low-density lipoproteins (LDL)
- Loss of appetite
- Severe cough or shortness of breath with tension (which was not before the start of amiodarone)
Serious side effects
You should call your doctor immediately if you experience the following serious side effects:
- Chronic heart failure
- Slow heartbeat (bradycardia)
- Atrioventricular (AV) block or sinoatrial (SA) node block
- Inflammation of the liver, including loss of liver function (cirrhosis)
- Eye problems
- Blood disorders
- Inflammation of the pancreas
- Allergic reactions
- Strong skin reactions
Rare side effects of amiodarone:
Although not often, some patients taking amiodarone may notice a bluish or blue-gray skin tone (ceruloderma).
In rare cases, patients who took amiodarone for prolonged periods of time and at higher doses may begin to see yellowish halos due to the accumulation of small bodies of fat on the eyes, known as micro corncrops.
It is reported that this side effect occurs approximately seven months after stopping amiodarone.
Another rare side effect is a condition known as demyelinating polyneuropathy, which can lead to partial or permanent blindness.
Tell your doctor about all the medicines that you take.
You should not take amiodarone if you take the following drugs:
- Heart rate control medications such as Ticosin (dofetilide), Multtac (dronedarone), Hidden (ibutilide), and procainamide
- Foradil and Perforomist (formoterol); Also found in Dulera and Symbicort
- Psychiatric drugs, such as Haldol (haloperidol) and Geodon (ziprasidone)
- Neupuvant or pentamidine (pentamidine)
- Orak (pimozide)
- Yuxtapid (Lomitapid)
- HIV / AIDS medications such as Crixivan (indinavir), Varipsept (nelfinazvir), Norvir (ritonavir) and Fortavaza or Invirase (saquinavir)
Other drugs that have severe interactions with amiodarone include:
- Antidepressants, such as Pamelor (nortriptyline), Effexor (venlafaxine), Celexa (citalopram)
- Antibiotics such as Zithromax (azithromycin), Biaxin (clarithromycin), Cipro (ciprofloxacin),
- Invicek (telapravir)
- Statins such as Lipitor (atorvastatin), Mevacor (lovastatin), or Zocor (simvastatin)
- Clozaryl (clozapine), Seroquel (quetiapine), Invega (paliperidone)
- Cancer medications such as Gleevec (imatinib), Eligard, Lupaneta or Lupron (leyoprolide) and Xalkori (crizotinib)
- Diflucan (fluconazole), Nizoral (ketoconazole), Vfend (voriconazole) and Sporonax or Omnel (itraconazole)
- St. John’s wort
Amiodarone and alcohol
Avoid or limit the use of alcohol while taking amiodarone.
The use of alcohol increases the risk of side effects of the drug.
Amiodarone and grapefruit
You should avoid eating grapefruit and grapefruit juice while taking amiodarone.
Grapefruit juice slows down the process when the body is able to destroy the medicine, which can lead to an increase in the level of amiodarone in the blood.
Dosage of amiodarone
Amiodarone is available in the form of tablets or as an injection liquid. The injection should be provided in the hospital by a qualified health professional.
Patients taking amiodarone for the first time are usually carefully monitored by a healthcare professional to help determine if their body can tolerate the drug.
Amiodarone tablets are available in dosages of 100 mg (mg), 200 mg and 400 mg, they are taken orally.
When you first start taking amiodarone, your doctor can prescribe for you a higher dose (800 to 1600 mg per day) for one to three weeks until your body begins to respond to the drug. Then your dose can be reduced (from 400 mg to 600 mg per day).
In children, the dose of amiodarone usually does not exceed more than 400 mg per day.
Amiodarone can be taken with or without food, but you should always take it with a full glass of water.
You should expect regular follow-up visits and work with blood when taking this medication to make sure that your body responds well to this drug.
Overdose of amiodarone
If you suspect an overdose, immediately contact a poison control center or an emergency room.
The missed dose of amiodarone
If you miss a dose of amiodarone, try to take it as soon as you remember.
However, if it’s time for the next dose, skip it and continue your regular schedule.
Do not double the dose to make up for the missed one.