Amiodarone HCl Injection Rx
Generic Name and Formulations:
Amiodarone HCl 50mg/mL; soln for IV infusion after dilution; contains polysorbate 80.
Various generic manufacturers
Indications for Amiodarone HCl Injection:
Documented, life-threatening recurrent refractory ventricular fibrillation or hemodynamically unstable ventricular tachycardia when oral therapy is not feasible.
Individualize. Loading infusions: 150mg over the first 10 mins (15mg/min) by rapid IV infusion, then 360mg over the next 6hrs (1mg/min) by slow IV infusion. Maintenance infusion: 540mg over the remaining 18hrs (0.5mg/min) by slow IV infusion. Switching to oral amiodarone: see full labeling.
Severe sinus node dysfunction. 2nd- or 3rd-degree AV block. Bradycardia with syncope unless paced. Cardiogenic shock.
Be experienced with the treatment and monitoring of life-threatening arrhythmias before prescribing this medication. Before use, correct potassium and magnesium deficiencies. Increased risk of pulmonary toxicity or liver injury; monitor, reduce dose or discontinue if either occurs. Perform baseline pulmonary function tests at initiation, then every 3–6 months. Surgery. Monitor thyroid function. Assess implantable cardiac devices. Do regular ophthalmic exams. Withdraw cautiously. Elderly. Pregnancy (Cat.D). Nursing mothers: not recommended.
Interactions may persist months after discontinuing. Potentiates antiarrhythmics (eg, quinidine, procainamide; reduce their doses by ⅓ to ½), cyclosporine, digoxin (reduce digoxin dose by ½ or discontinue), oral anticoagulants (reduce anticoagulant dose by ⅓ to ½ and monitor PT), phenytoin, lidocaine, dextromethorphan. Myopathy with statins metabolized by CYP3A4; limit simvastatin dose to 20mg daily or lovastatin dose to 40mg daily. Potentiated by protease inhibitors, loratadine, cimetidine, trazodone, grapefruit juice. Exacerbation of arrhythmias with antiarrhythmics. Additive bradycardia, AV block with β-blockers, calcium channel blockers, fentanyl. QTc prolongation with quinolones, macrolides, azole antifungals, disopyramide. Antagonized by rifampin, St. John's wort, cholestyramine. May affect thyroid function tests. See full labeling.
Class III antiarrhythmic.
Hypotension, alveolitis, pulmonary inflammation or fibrosis, post-op adult respiratory distress syndrome, exacerbation of arrhythmias, heart block or failure, sinus bradycardia, hepatotoxicity, corneal deposits, optic neuropathy/neuritis (reevaluate if occurs), photosensitivity, skin pigmentation, thyroid disorders, malaise, peripheral neuropathy, constipation, anorexia, blood dyscrasias, pancreatitis; peripheral vein phlebitis (w. concentrated solutions; see full labeling).
Formerly known under the brand name Cordarone.
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