What Is Amiodarone (Cordarone)?
Heart arrhythmias can occur in conditions such as ventricular arrhythmias, atrial fibrillation (AF), or hypertrophic cardiomyopathy (thickening of the walls of the heart).
Amiodarone may also be prescribed off-label for children to help treat irregular heartbeat.
Amiodarone belongs to group of drugs known as anti-arrhythmics. There are four major classes of anti-arrhythmics, and amiodarone belongs to Class III. It works by:
- Blocking receptors that use adrenaline
- Slowing or preventing the passing of sodium out of heart cells
- Decreasing the electrical activity in the heart
- Increasing the activity time for contraction in the heart
Amiodarone Warnings
Amiodarone has two black-box warnings for having the potential to cause the risk of sudden death and potentially deadly side effects including:- Lung damage, including fibrosis (scarring) or inflammation of the lungs
- Liver damage or inflammation, including causing abnormal levels of liver function tests (LFTs)
- Irregular heartbeat or heart rhythm. (Note that medications that are taken for arrhythmias can also cause arrhythmias.)
You should NOT take amiodarone if:
- You are allergic to amiodarone or any of the inactive ingredients
- Have severe abnormal function of the sinus node or 2/3 sinus block
Talk to your doctor before taking amiodarone if you:
- Are sensitive to sunlight
- Have thyroid problems
- Have a pacemaker
- Have heart disease or heart conditions, including heart block, slow heartbeat, enlarged heart, and/or low blood pressure
- Are taking warfarin (amiodarone can increase risk of bleeding)
- Have an existing lung disease (e.g., pulmonary fibrosis or chronic obstructive pulmonary disease)
Pregnancy and Amiodarone
Amiodarone is in FDA Pregnancy Category D, which means it should only be taken in situations when there are no other options available because it could harm the fetus.Regardless, you should tell your doctor if you are pregnant or plan to become pregnant before taking this medication.
Amiodarone is not recommended for breastfeeding women, so make sure to tell your physician if you are breastfeeding or plan to breastfeed.
Amiodarone (Cordarone) Side Effects
Common Side Effects of Amiodarone
You should tell your doctor if any of the following side effects become severe or don't go away:- Low blood pressure
- Dizziness or headache
- Awkward stance and walking
- Memory loss
- Restlessness
- Shaking and uncontrollable movement
- Tiredness and trouble sleeping
- Sensitivity to the sun
- Low levels of thyroid hormone
- Increased cholesterol levels, including triglycerides and low-density lipoproteins (LDL)
- Loss of appetite
- Severe cough or shortness of breath with exertion (that wasn't present before starting amiodarone)
Serious Side Effects of Amiodarone
You should call your doctor immediately if you experience any of the following serious side effects:- Congestive heart failure
- Slowed heart beat (bradycardia)
- Atrioventricular (AV) block or sinoatrial (SA) node block
- Overactive thyroid
- Inflammation of the liver, including lost liver function (cirrhosis)
- Problems with vision (seeing halos or yellowish colors)
- Blood disorders
- Inflammation of the pancreas
- Allergic reactions
- Nerve damage (when taken for long periods of time)
- Severe skin reactions
Rare Side Effects of Amiodarone:
Although not common, some patients taking amiodarone may notice a bluish or gray-blue tint to the skin (ceruloderma).In rare cases, patients who have taken amiodarone for long periods of time and in higher doses may begin to see yellowish halos due to a build-up of small bodies of fat on the eye, known as corneal microdeposits. This side effect reportedly goes away roughly seven months after stopping amiodarone.
Another rare side effect is a condition known as demyelinating polyneuropathy, which can lead to partial or permanent blindness.
Monitoring
It's recommended that all patients on amiodarone have a test of their lung function (called a pulmonary function test) before or just after starting amiodarone and yearly during therapy.This is advised to monitor for the possible side effect of pulmonary fibrosis.
Amiodarone (Cordarone) Interactions
You should not take amiodarone if you are taking the following drugs:
- Medications to control heart rhythm like Tikosyn (dofetilide), Multaq (dronedarone), Covert (ibutilide), and procainamide
- Foradil and Perforomist (formoterol); also found in Dulera and Symbicort
- Psychiatric medications like Haldol (haloperidol) and Geodon (ziprasidone)
- Nebupent or Pentam (pentamidine)
- Orap (pimozide)
- Juxtapid (Lomitapide)
- HIV/AIDS medications like Crixivan (indinavir), Varicept (nelfinazvir), Norvir (ritonavir), and Fortavase or Invirase (saquinavir)
- Medications for depression like Pamelor (nortriptyline), Effexor (venlafaxine), Celexa (citalopram)
- Antibiotics like Zithromax (azithromycin), Biaxin (clarithromycin), Cipro (ciprofloxacin),
- Invicek (telapravir)
- Cholesterol medications like Lipitor (atorvastatin), Mevacor (lovastatin), or Zocor (simvastatin)
- Clozaril (clozapine), Seroquel (quetiapine), Invega (paliperidone)
- Cancer medications like Gleevec (imatinib), Eligard, Lupaneta, or Lupron (leuoprolide), and Xalkori (crizotinib)
- Diflucan (fluconazole), Nizoral (ketoconazole), Vfend (voriconazole), and Sporonax or Omnel (itraconazole)
- The herbal supplement St. John's wort
Amiodarone and Alcohol
Avoid or limit drinking alcohol while taking amiodarone. Alcohol use increases the risk that you'll experience side effects of the drug.Amiodarone and Grapefruit
You should avoid eating grapefruit and drinking grapefruit juice while taking amiodarone.Grapefruit juice slows down how quickly the body is able to break down the medication, which could cause amiodarone levels in the blood to rise dangerously high.
Amiodarone (Cordarone) Dosage
Patients receiving amiodarone for the first time are normally closely monitored by healthcare professional to help determine whether their body can tolerate the drug.
Amiodarone tablets are available in 100 milligram (mg), 200 mg, and 400 mg tablets taken by mouth.
When you first start taking amiodarone, your doctor may put you on a higher dose (ranging from 800 to 1600 mg per day) for one to three weeks until your body starts to respond to the drug. Then, your dose may be decreased (ranging from 400 mg to 600 mg per day).
In children, the dose of amiodarone is normally based on the child's body surface area (BSA), and normally ends being no 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 to have regular follow-up visits and blood work done while taking this drug to make sure your body is responding well to the drug.
Amiodarone Overdose
If you suspect an overdose, contact a poison control center or emergency room immediately. You can get in touch with a poison control center at (800) 222-1222.Missed Dose of Amiodarone
If you miss a dose of amiodarone, try to take it as soon as you remember.However, if it is almost time for the next dose, skip the missed dose and continue on your regular schedule. Don't double up on doses to make up for a missed one.
Amiodarone Pictures
