Amiodarone | Side Effects, Dosage, Uses & More (original) (raw)
This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.
- Amiodarone should only be used if you have a life threatening arrhythmia or irregular heart rate. This medication has the risk of serious side effects. These include serious lung problems, liver problems, and a worsening of your irregular heart rate. These problems can be fatal.
- If you need to be treated with amiodarone for an irregular heart rate, you’ll need to be admitted into the hospital to get the first dose. This is to make sure that amiodarone is given to you safely and it’s effective. You may need to be monitored in the hospital when the dose is adjusted.
- Amiodarone oral tablet is available as a generic drug and as a brand-name drug. Brand name: Pacerone.
- Amiodarone is also available as a solution for injection. You may start with the oral tablet in the hospital and continue to take the tablet at home. In rare cases, your doctor may start you with the injection at the hospital and give you the oral tablet to take at home.
- Amiodarone is used to treat the heart rate problems ventricular fibrillation and ventricular tachycardia.
Amiodarone oral tablet is a prescription drug that’s available as the brand-name drug Pacerone. It’s also available in its generic form. Generic drugs usually cost less than brand-name versions.
Amiodarone also comes as an intravenous (IV) solution for injection, which is only given by a healthcare provider.
This drug may be used as part of a combination therapy. That means you need to take it with other drugs.
Why it’s used
Amiodarone is used to treat heart rate problems that are life threatening. It’s usually given when other drugs haven’t worked.
How it works
Amiodarone belongs to a class of drugs called antiarrhythmics. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.
Amiodarone treats and prevents abnormal heartbeats by working inside cells to control muscle contractions in the heart. This helps your heart beat normally.
Amiodarone can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking amiodarone.
This list does not include all possible side effects. For more information on the possible side effects of amiodarone, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.
Amiodarone oral tablet does not cause drowsiness, but it can cause other side effects.
More common side effects
The most common side effects that can occur with amiodarone oral tablet include:
- nausea
- vomiting
- fatigue
- tremor
- lack of coordination
- constipation
- insomnia
- headache
- stomach pain
- decreased sex drive or performance
- uncontrollable or unusual movements of the body
If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.
Serious side effects
Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
- Allergic reactions. Symptoms can include:
- skin rash
- itching
- hives
- swelling of your lips, face, or tongue
- Lung problems. Symptoms can include:
- wheezing
- trouble breathing
- shortness of breath
- coughing
- chest pain
- spitting up blood
- Vision changes. Symptoms can include:
- blurred vision
- increased sensitivity to light
- vision problems such as seeing blue or green halos (circles around objects)
- Liver problems. Symptoms can include:
- unusual tiredness or weakness
- dark urine
- yellowing of your skin or the whites of your eyes
- Heart problems. Symptoms can include:
- chest pain
- fast or irregular heart rate
- feeling lightheaded or faint
- unexplained weight loss or weight gain
- Stomach problems. Symptoms can include:
- spitting up blood
- stomach pain
- nausea or vomiting
- Thyroid problems. Symptoms can include:
- decreased tolerance to heat or cold
- increased sweating
- weakness
- weight loss or weight gain
- thinning hair
- Pain and swelling of your scrotum
- Nerve damage. Symptoms can include:
- pain, tingling, or numbness in your hands or feet
- muscle weakness
- uncontrolled movements
- trouble walking
- Serious skin reactions. Symptoms can include:
- blue-gray skin color
- severe sunburn
The amiodarone dosage your doctor prescribes will depend on several factors. These include:
- the type and severity of the condition you’re using amiodarone to treat
- your age
- the form of amiodarone you take
- other medical conditions you may have
Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.
This dosage information is for amiodarone oral tablet. All possible dosages and forms may not be included here.
Forms and strengths
Generic: Amiodarone
- Form: oral tablet
- Strengths: 100 mg, 200 mg, 400 mg
Brand: Pacerone
- Form: oral tablet
- Strengths: 100 mg, 200 mg
A healthcare provider will give you the first dose of amiodarone in a doctor’s office or hospital. After that, you’ll take your doses of amiodarone at home.
Dosage for ventricular fibrillation
Adult dosage (ages 18–64 years)
Starting dosage:
- 800–1,600 mg per day taken by mouth in either a single dose or separated doses for 1–3 weeks.
- You’ll be closely monitored during this time to make sure that you respond to the treatment.
Continuing dosage:
- 600–800 mg per day taken by mouth in a single dose or separated doses for 1 month.
- The dose will be lowered to a maintenance dose. This is usually 400 mg per day taken by mouth in a single dose or separated doses.
Child dosage (ages 0–17 years)
The safety and effectiveness of amiodarone have not been established in people under the age of 18 years.
Senior dosage (ages 65 years and older)
Your dosage will be started on the low end to reduce the risk of side effects. In general, as you age, your organs, such as your liver, kidneys, and heart, don’t work as well as they once did. More of the drug may stay in your body and put you at an increased risk for side effects.
Special considerations
- For people with kidney problems. If you have kidney problems, your body won’t be able to clear this drug as well. This may cause the drug to build up in your body and cause more side effects. Your doctor may start you at a lower dosage. If your kidney function gets worse, your doctor may stop your medication.
- For people with liver problems. If you have liver problems, your body won’t be able to clear this drug as well. This may cause the drug to build up in your body and cause more side effects. Your doctor may start you at a lower dosage. If your liver function gets worse, your doctor may stop your medication.
Dosage for ventricular tachycardia
Adult dosage (ages 18–64 years)
Starting dosage:
- 800–1,600 mg per day taken by mouth in either a single dose or separated doses for 1–3 weeks.
- You will be closely monitored during this time to make sure that you respond to the treatment.
Continuing dosage:
- 600–800 mg per day taken by mouth in a single dose or separated doses for 1 month.
- The dose will be lowered to a maintenance dose. This is usually 400 mg per day taken by mouth in a single dose or separated doses.
Child dosage (ages 0–17 years)
The safety and effectiveness of amiodarone have not been established in people under the age of 18 years.
Senior dosage (ages 65 years and older)
Your dosage will be started on the low end to reduce the risk of side effects. In general, as you age, your organs, such as your liver, kidneys, and heart, don’t work as well as they once did. More of the drug may stay in your body and put you at an increased risk for side effects.
Special considerations
- For people with kidney problems. If you have kidney problems, your body won’t be able to clear this drug as well. This may cause the drug to build up in your body and cause more side effects. Your doctor may start you at a lower dosage. If your kidney function gets worse, your doctor may stop your medication.
- For people with liver problems. If you have liver problems, your body won’t be able to clear this drug as well. This may cause the drug to build up in your body and cause more side effects. Your doctor may start you at a lower dosage. If your liver function gets worse, your doctor may stop your medication.
Amiodarone oral tablet can be used for long-term or short-term treatment. Your doctor will determine how long you’ll be treated with amiodarone depending on how well your body responds to it. This drug comes with serious risks if you don’t take it as prescribed.
If you don’t take it at all or skip doses. If you don’t take amiodarone as prescribed, you may be at risk for serious heart problems.
If you take too much. If you think you’ve taken too much amiodarone, go to the emergency room right away, or call your local poison control center.
What to do if you miss a dose. If you miss a dose, take it as soon as you remember. If it’s almost time for your next dose, take only one dose at that time. Don’t take extra doses or double up on doses to make up for the missed dose.
How to tell if the drug is working: You may be able to tell if this medication is working if your symptoms improve. Your dizziness, nausea, chest pain, shortness of breath, or rapid heart rate should get better.
This drug comes with various warnings.
Sun sensitivity warning
Amiodarone may make you more sensitive to the sun or make your skin turn a blue-gray color.
Try to avoid the sun while taking this drug. Wear sunscreen and protective clothing if you know you’ll be out in the sun. Don’t use sun lamps or tanning beds.
Risk of vision problems
You should have regular eye exams during treatment with amiodarone.
Amiodarone may can cause vision problems, including blurred vision, seeing halos around objects, or sensitivity to light. You should call your doctor if you experience any of these side effects.
Risk of lung problems
In some cases, amiodarone can cause lung injury that can be fatal. You may be at greater risk if you already have lung disease.
Call your doctor right away if you notice any shortness of breath, wheezing, trouble breathing, chest pain, or spitting up blood while taking this drug.
Allergy warning
Don’t take this drug again if you have ever had an allergic reaction to it. Taking it again could be fatal.
Food interactions warning
Don’t drink grapefruit juice while taking this drug. Drinking grapefruit juice while taking amiodarone may increase the amount of amiodarone in your body.
Warnings for people with certain health conditions
For people with an iodine allergy. Don’t use this drug. It contains iodine.
For people with heart failure or heart disease. Use amiodarone with caution. This drug may weaken your heart’s contractions and slow your heart rate.
Don’t use amiodarone if you have severe sinus node dysfunction with a slow heart rate, fainting due to slow heart rate, second- or third-degree heart block, or if your heart suddenly cannot pump enough blood throughout your body (cardiogenic shock).
For people with lung disease. Use amiodarone with extreme caution if you have lung disease, such as chronic obstructive pulmonary disease (COPD), or if your lungs don’t work well. Amiodarone may cause toxic side effects to your lungs and may even be fatal.
For people with liver disease. Use amiodarone with caution if you have liver disease, such as cirrhosis or liver damage. These conditions may cause amiodarone to build up in your body and be toxic to your liver.
For people with thyroid disease. If you have thyroid disease, you may experience low or high thyroid hormone levels while taking amiodarone. This may make your condition worse.
For people with nerve disease. Use amiodarone with caution if you have any neurological disease, such as peripheral neuropathy, Parkinson’s disease, muscular dystrophy, or epilepsy. Taking this drug may cause nerve damage and make these conditions worse.
Warnings for other groups
For pregnant women. Amiodarone can harm your pregnancy if you take this drug while pregnant. Tell your doctor if you’re pregnant or plan to become pregnant, even if you’re stopping treatment with amiodarone. This drug can stay in your body for months after treatment has stopped.
For women who are breastfeeding. Amiodarone may pass through breast milk and cause serious effects in a breastfeeding child. You should not breastfeed while taking amiodarone. Talk to your doctor about the best way to feed your child.
For seniors. In general, as you age, your organs, such as your liver, kidneys, and heart, don’t work as well as they once did. More of the drug may stay in your body and put you at an increased risk for side effects.
For children. The safety and effectiveness of amiodarone haven’t been established in people under the age of 18 years.
Amiodarone can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.
Below is a list of medications that can interact with amiodarone. This list does not contain all drugs that may interact with amiodarone.
Before taking amiodarone, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take.
Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.
Antibiotics
Taking certain antibiotics with amiodarone may cause an irregular heart rate. Examples of these drugs include:
- erythromycin
- clarithromycin
- fluconazole
- levofloxacin
Antiviral drugs
These medications may increase the amount of amiodarone in your body. This puts you at a higher risk for serious side effects from amiodarone, including irregular heart rate, which may be fatal.
Your doctor will monitor you closely if you take these drugs together. Examples of these drugs include:
- atazanavir (Reyataz)
- darunavir (Prezista)
- fosamprenavir (Lexiva)
- indinavir (Crixivan)
- lopinavir and ritonavir (Kaletra)
- nelfinavir (Viracept)
- ritonavir (Norvir)
- saquinavir (Invirase)
- tipranavir (Aptivus)
Blood thinners
Taking blood thinners such as warfarin with amiodarone may increase the effect of the blood thinner. This puts you at risk for serious bleeding, which may be fatal.
If you take these drugs together, your doctor should decrease the dosage of your blood thinner and monitor you closely.
Cough medication, over-the-counter
Using dextromethorphan with amiodarone may increase the amount of dextromethorphan in your body, which may lead to toxicity.
Depression drug
Trazodone may increase the amount of amiodarone in your body. This puts you at a higher risk for serious side effects from amiodarone, including irregular heart rate, which may be fatal.
Drug to prevent organ transplant rejection
Taking cyclosporine with amiodarone leads to increased amounts of cyclosporine in your body. This may cause serious side effects.
GERD drug
Taking cimetidine with amiodarone may increase the amount of amiodarone in your body. This puts you at a higher risk for serious side effects from amiodarone, including irregular heart rate, which may be fatal.
Heart failure medication
Taking ivabradine with amiodarone may slow your heart rate and cause heart rhythm disorders. Your doctor may monitor your heart function closely if you take these drugs together.
Heart medications
Taking amiodarone with certain heart medications may increase the levels of the heart drugs in your body. This can lead to serious side effects that may be fatal.
If you take one of these drugs with amiodarone, your doctor may reduce the dosage of the heart drug. Examples of these drugs include:
- digoxin
- antiarrhythmics, such as:
- quinidine
- procainamide
- flecainide
Hepatitis drugs
Taking certain hepatitis medications with amiodarone can cause serious bradycardia, which is slowing of your heart rate. This can be life threatening.
Your doctor will likely monitor your heart rate if you take either of these drugs with amiodarone:
- ledipasvir/sofosbuvir (Harvoni)
- sofosbuvir with simeprevir
Herbal supplement
Taking St. John’s wort with amiodarone may lower the amount of amiodarone in your body, which means that it won’t work as well.
High blood pressure medications
Use these drugs with caution while you’re taking amiodarone. Using these medications with amiodarone may cause side effects to your heart.
Examples of these drugs include:
- beta-blockers, such as:
- acebutolol
- atenolol
- bisoprolol
- carteolol
- esmolol
- metoprolol
- nadolol
- nebivolol
- propranolol
- calcium channel blockers, such as:
- amlodipine
- felodipine
- isradipine
- nicardipine
- nifedipine
- nimodipine
- nitrendipine
High cholesterol drugs
Taking statins with amiodarone may increase the level of the cholesterol medications in your body, which can cause side effects.
Your doctor may lower your dosage of these medications while you’re taking amiodarone. Examples of these drugs include:
- simvastatin
- atorvastatin
Also, taking cholestyramine with amiodarone may lower the amount of amiodarone in your body, which means that it won’t work as well.
Local anesthesia drug
Using lidocaine with amiodarone may cause a slow heart rate and seizures.
Pain medication
Using fentanyl with amiodarone may slow your heart rate, lower your blood pressure, and reduce the amount of blood your heart pumps.
Seasonal allergy drug
Loratadine may increase the amount of amiodarone in your body. This puts you at a higher risk for serious side effects from amiodarone, including irregular heart rate, which may be fatal.
Seizure drug
Taking phenytoin with amiodarone may lower the amount of amiodarone in your body, which means that it won’t work as well.
Tuberculosis drug
Taking rifampin with amiodarone may lower the amount of amiodarone in your body, which means that it won’t work as well.
Keep these considerations in mind if your doctor prescribes amiodarone oral tablet for you.
General
- You can take this drug with or without food. However, you should take it the same way each time.
- Take amiodarone at the same times every day, at regular intervals.
Storage
- Store this drug at a temperature between 68°F and 77°F (20°C and 25°C).
- Protect this drug from light.
Refills
A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.
Travel
When traveling with your medication:
- Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
- Don’t worry about airport X-ray machines. They can’t hurt your medication.
- You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
- Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.
Clinical monitoring
You’ll be monitored closely while you’re taking amiodarone. Your doctor will check your:
- liver
- lungs
- thyroid
- eyes
- heart
You’ll also get a chest X-ray and blood tests. Your doctor will do blood tests that check how much amiodarone is in your blood to make sure it’s safe for you.
Sun sensitivity
Amiodarone may make you more sensitive to sunlight. Try to avoid the sun while taking this drug. Wear sunscreen and protective clothing if you’ll be in the sun. Don’t use sun lamps or tanning beds.
Insurance
Many insurance companies will require a prior authorization before they approve the prescription and pay for amiodarone.
There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.