Amiodarone

Therapeutic Group

Cardiac Therapy

Indication Dosage

Amiodarone is primarily prescribed to treat irregular heart rhythms, specifically ventricular arrhythmias and atrial fibrillation when other antiarrhythmic drugs have proven ineffective. It helps restore and maintain a regular heart rhythm, reducing the risk of life-threatening cardiac arrhythmias.

Treatment Of Arrhythmias, Particularly When Other Drugs Are Ineffective Or Contra-indicated, Including Paroxysmal Supraventricular, Nodal, And Ventricular Tachycardias, Atrial Fibrillation And Flutter, Ventricular Fibrillation, And Tachyarrhythmias Associated With Wolff-Parkinson-white Syndrome: 

Oral:

  • Adult: 200 Mg 3 Times A Day For 1 Week, Then Reduced To 200 Mg Twice Daily For A Further Week, Followed By Maintenance Dose, Usually 200mg Daily Or The Minimum Dose Required To Control Arrhythmia 
  • Children 3-12 Yrs: Initially 5-10 Mg/kg (max 200 Mg) Twice Daily For 7-10 Days, Then Reduced To Maintenance Dose Of 5-10 Mg/kg Once Daily (max 200 Mg Daily); 12-18 Yrs: 200 Mg 3 Times Daily For 1 Wk Then 200 Mg Twice Daily For 1 Wk Then Usually 200mg Daily Adjusted According To Response.

By IV Infusion: 

  • Adult: Initially 5 Mg/kg, To Be Given Over 20-120 Minutes With Ecg Monitoring, Subsequent Infusions Given If Necessary According To Response; Maximum 1.2 G Per Day 
  • Children 3-18 Yrs: Initially 5-10 Mg/kg Over 20 Minutes-2 Hr Then By Continuous Infusion 300 Mcg/ Kg/hr, Increased According To Response To Max. 1.5 Mg/kg/ Hr; Do Not Exceed 1.2 Gm/24 Hr 

Ventricular Fibrillation Or Pulseless Ventricular Tachycardia Refractory To Defibrillation For Cardiopulmonary Resuscitation: 

By IV Inj: 

  • Adult: Initially 300 Mg, Dose To Be Considered After Administration Of Adrenaline, Dose Should Be Given From A Pre-filled Syringe Or Diluted In 20ml Glucose 5%, Then 
    By IV Inj 150 Mg If Required, Followed By (by Iv Infusion) 900 Mg/24 Hours 
  • Children 3-18 Yr: 5 Mg/ Kg (max 300 Mg) Over At Least 3 Minutes Below 3 Yr, Not Recommended.

Content

  • Inj: Per 3 ml Amp: Amiodarone Hci 150mg.
  • Tab 100mg /200mg: amiodarone Hci 100mg / 200mg

Pregnancy

Positive Evidence Of Risk, Use Only When No Safer Alternative Exists For A Serious Problem.

Stability

  • Anti-arrhythmic

Contra Indications

  • Avoid In Severe Conduction Disturbances And In Sinus Node Disease, Iodine Sensitivity, Sino-atrial Heartblock And Sinus Bradycardia (except In Cardiac Arrest), Thyroid Dysfunction. With Intravenous Use Avoid Bolus Injection In Cardiomyopathy, Avoid Bolus Injection In Congestive Heart Failure, Circulatory Collapse, Severe Arterial Hypotension, Severe Respiratory Failure, All Kinds Of Conduction Delays, Pulmonary Fibrosis, Severe Liver Parenthetic Damage, Women Of Child Bearing Age.

Precautions

  • Avoid In Severe Conduction Disturbances And In Sinus Node Disease, Iodine Sensitivity, Sino-atrial Heartblock And Sinus Bradycardia (except In Cardiac Arrest), Thyroid Dysfunction. With Intravenous Use Avoid Bolus Injection In Cardiomyopathy, Avoid Bolus Injection In Congestive Heart Failure, Circulatory Collapse, Severe Arterial Hypotension, Severe Respiratory Failure, All Kinds Of Conduction Delays, Pulmonary Fibrosis, Severe Liver Parenthetic Damage, Women Of Child Bearing Age.

Lactation

  • Contraindicated, Risk of Neonatal Hypothyroidism from Release of Iodine.

Side Effects

  • Pulmonary Toxicity
  • Disturbances Of Liver & Thyroid Function
  • Bradycardia
  • Hyperthyroidism
  • Hypothyroidism
  • Jaundice
  • Nausea
  • Phototoxicity
  • Raised Serum Transaminases
  • Reversible Corneal Microdeposits
  • Taste Disturbances
  • Tremor
  • Vomiting
  • Hot Flushes
  • Hypotension
  • Respiratory Distress Syndrome
  • Sweating.
  • Rare: Peripheral Myopathy And Peripheral Neuropathy (reversible Onwithdrawal).
  • Rare: Alopecia
  • Haemolyticanaemia
  • Aplastic Anaemia
  • Ataxia
  • Chronic Liver Disease
  • Sinus Arrest
  • Thrombocytopenia
  • Vasculitis
  • Vertigo.

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