Advertisement

Amiodarone, Oral Tablet

Highlights for amiodarone

  1. Amiodarone oral tablet is available as a generic drug and as a brand-name drug. Brand name: Pacerone.
  2. 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.
  3. Amiodarone is used to treat the heart rate problems ventricular fibrillation and ventricular tachycardia.
Advertisement
Advertisement

Important warnings

Important warnings

FDA warning: Serious side effects warning
  • This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning 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, worsening of your irregular heart rate, and loss of vision. 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 is effective. You may need to be monitored in the hospital when the dose is adjusted.
  • 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: Amiodarone may cause your eyes to get dry. If this happens, ask your doctor or pharmacist to suggest an over-the-counter lubricating eye solution or artificial tears solution. You should call your doctor if you see halos around objects, if you have blurred vision, or if your eyes become sensitive to light while taking this drug.
  • 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.

About

What is amiodarone?

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.

Advertisement
Advertisement
Advertisement

Side effects

Amiodarone side effects

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

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Interactions

Amiodarone may interact with other medications

Amiodarone oral tablet can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to 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.

Examples of drugs that can cause interactions with amiodarone are listed below.

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 medicine, over-the-counter

Using dextromethorphan with amiodarone may increase the amount of dextromethorphan in your body. This 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. This 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. This 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. This 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 being pumped by your heart.

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. This means that it won’t work as well.

Tuberculosis drug

Taking rifampin with amiodarone may lower the amount of amiodarone in your body. This means that it won’t work as well.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Advertisement
Advertisement

Other warnings

Amiodarone warnings

This drug comes with several warnings.

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 are 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.

Advertisement

Dosage

How to take amiodarone

This dosage information is for amiodarone oral tablet. All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

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, 400 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:

  • 800–1600 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 one 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:

  • 800–1600 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 one 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.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.

Advertisement
Advertisement

Take as directed

Take as directed

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.

Important considerations

Important considerations for taking amiodarone

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 you 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.

Advertisement
Advertisement
Advertisement

Alternatives

Are there any alternatives?

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.

Article Resources
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement