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Terms Of Use

AMIODARONE

Brand Name(s) : Codarone, Amyben
Warnings
Uses
Side Effects
Precautions
Interactions
Overdose

AMIODARONE WARNINGS

Amiodarone should be used with caution in: the elderly, the inherited condition porphyria, liver problems, heart failure, lung problems including asthma, eyesight problems including optic neuritis, low blood pressure, patients who are about to have an operation, low bloodpotassium levels, patients with a pacemaker or an implantable cardioverter defibrillator (ICD), patients with an intolerance to certain sugars.

It should not be used in:patients who are allergic to amiodarone, iodine or to any other ingredients in the medicine, heart failure, weak heart (cardiomyopathy), slower than usual heartbeat (sinus bradycardia) or sino-atrial heart block, patients with other problems with their heartbeat who do not have a pacemaker, history of problems with the thyroid gland or patients who have not had their thyroid function tested, patients taking other medicines that could affect their heartbeat (see drug interactions section), pregnancy or breastfeeding. In addition, intravenous use should be avoided in severe breathing problems, very low blood pressure, serious blood circulation problems,.

Also see list of precautions and interactions

STORAGE

Do not store above 25ºC.

AMIODARONE USES

What is it used for?

  • Amiodarone is used to control the uneven beating of your heart also known as an arrhythmia.
  • It is an anti-arrhythmic drug.
  • It is used to help keep the heart beating normally in patients with serious disorders of their heart rhythm. It affects the electrical activity of the heart which is responsible for the heart's rhythm.
  • In general this drug is used to treat serious arrhythmias of the heart.
  • Benefits of being on this drug can include controlling uneven heartbeat and help the heartbeat return to normal.

Listed below are the typical uses of amiodarone.

  • Treat uneven heartbeats when other medicines have not worked or cannot be used
  • Unusually fast heart beats (Wolff-Parkinson-White syndrome)
  • Other types of fast or uneven heart beat (atrial flutter or atrial fibrillation)
  • Sudden and sometimes uneven fast heart beats

On occasion your doctor may prescribe this medicine to treat a condition not on the above list. Such conditions are listed below.

  • In an emergency when the heartbeat is very irregular or very fast.

HOW TO USE/TAKE

How often do I take it?

  • Treatment with amiodarone is normally under hospital or specialist supervision. Take this medicine exactly as advised by your doctor. The usual dose is one 200mg tablet three times each day for the first week, followed by one 200mg twice each day for the second week and then one 200mg once each day. In some patients this may be reduced to one 100mg tablet daily. Amiodarone may be taken with or without food. Swallow the tablets whole, do not crush or chew.
  • Other formulations may need to be taken more or less frequently as indicated by your doctor or pharmacist.
  • Use this medication regularly in order to get the most benefit from it.
  • Remember to use it at the same time each day - unless specifically told not to by your doctor.
  • It may take several weeks or months before the full benefit of this drug takes effect.
  • Certain medical conditions may require different dosage instructions as directed by your doctor.

What dose?

  • Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.

Do I need to avoid anything?

  • Do not drink grapefruit juice whilst taking amiodarone. Keep out of direct sunlight while taking this medicine and for a few months after you have finished taking it as your skin will be more sensitive to the sun. Use a high factor sun cream and wear a hat and clothes which cover your arms and legs. Amiodarone may cause blurred eyesight or a sensation of spinning. If you experience these symptoms then do not drive or operate machinery. Consult your doctor or pharmacist for more details.

When can I stop?

  • It is important to continue taking this medication even if you feel well, unless your doctor tells you to stop.

AMIODARONE SIDE EFFECTS

  • Blurred eyesight or seeing a coloured halo in dazzling light.
  • Feeling very restless or agitated, weight loss, increased sweating and being unable to stand the heat (this may be a sign of an overactive thyroid).
  • Feeling very tired, weak or run down, weight gain, being unable to stand the cold, constipation and aching muscles (this may be a sign of an underactive thyroid).
  • Trembling when you move your arms or legs.
  • Blue or grey marks on parts of your skin exposed to sunlight, especially the face.
  • Muscle cramps, stiffness or spasm.
  • Swelling of the testicles.
  • Red scaly patches of skin, loss of hair or loosening of nails.
  • Feeling tired, faint, dizzy or having pale skin (this may be a sign of anaemia).
  • Bleeding or bruising more easily.
  • Feeling unwell, confused or weak, feeling sick, loss of appetite and feeling irritable.
  • Feeling sick or being sick
  • Change in the way things taste
  • Burning more easily in the sun
  • Changes in the functioning of the liver as seen in blood tests
  • Slightly slower heartbeat
  • Nightmares
  • Problems sleeping
  • Headache
  • Sweating
  • Hot flushes
  • Pain, swelling, irritation, reddening or skin discolouration around the area of injection (this applies to amiodarone injection only)
  • Feeling dizzy and balance problems (vertigo)
  • Difficulty in gaining or maintaining an erection or ejaculating
  • Hair loss
  • Skin redness during radiotherapy
  • Itchy, lumpy rash (hives).

If any of these persist or you consider them severe then inform your doctor or pharmacist as soon as possible.

Tell your doctor immediately and stop taking amiodarone if you develop any of the following symptoms:

  • Rash, swallowing or breathing problems, swollen eyelids, face, lips, throat or tongue (this may be a sign of an allergic reaction).
  • Yellowing of the skin or whites of the eyes, tiredness, feeling sick, loss of appetite, stomach pain or high temperature (this may be a sign of liver problems).
  • Difficulty breathing or tightness in the chest, coughing which will not go away, wheezing, weight loss, fever (this may be a sign of inflammation of the lungs).
  • Your heartbeat becomes even more uneven or erratic (this can lead to a heart attack so you should go to a hospital straight away).
  • Loss of sight in one eye or your eyesight becomes dim and colourless or your eyes feel sore, tender or painful to move (this may be a sign of the eye condition optic neuropathy or neuritis).
  • Your heartbeat becomes very slow or stops beating (go to a hospital straightaway if you have these symptoms).
  • Feeling of numbness or weakness, tingling or burning feelings in any part of your body.
  • Skin rash.
  • Headache which is usually worse in the morning or happens after coughing or straining, feeling sick, fitting, eyesight problems or confusion.
  • Moving unsteadily or staggering, slow or slurred speech.
  • Feeling faint, dizzy, unusually tired and short of breath (this may be a sign of a very slow heart beat).
  • Other problems with the heart's natural beat.
  • Coughing up blood.

Further information about other side effects can be found in the patient information leaflet.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

  • Feeling sick
  • Being sick
  • Stomach upset
  • Diarrhoea
  • Stomach bleeding
  • Problems with eyesight
  • Dizziness
  • Headache
  • Fast heart rate
  • Fast, strong heart beat (palpitations)
  • Irregular heart beat (arrhythmias)
  • Problems sleeping
  • Feeling restless
  • Feeling anxious
  • Feeling irritable
  • Feeling shaky
  • Confusion
  • Fast breathing
  • Spinning sensation
  • Fitting
  • Feeling thirsty
  • Ringing in the ears
  • Low blood pressure
  • Rash
  • Itching

If any of these persist or you consider them severe then inform your doctor or pharmacist.

Tell your doctor immediately if you develop any of the following symptoms:

  • Rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing (this may be a sign of an allergic reaction).

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website.

AMIODARONE PRECAUTIONS

Before taking amiodarone, tell your doctor or pharmacist if you are allergic to it; or to other anti-arrhythmics; or if you have any other allergies including to iodine.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist in case of: an allergy to amiodarone, iodine or to any other ingredients in the medicine, heart failure, weak heart (cardiomyopathy), slower than usual heartbeat (sinus bradycardia) or sino-atrial heart block, other problems with your heartbeat and you do not have a pacemaker, history of problems with the thyroid gland or you have not had your thyroid function tested, severe breathing problems, very low blood pressure, serious blood circulation problems, you are taking other medicines that could affect your heartbeat (see drug interactions section), you are pregnant or breastfeeding.

Before using this medication tell your doctor or pharmacist your medical history, especially any of the following the inherited condition porphyria, liver problems, lung problems including asthma, eyesight problems including optic neuritis, low blood pressure, you are about to have an operation, low blood potassium levels, you have a pacemaker or an implantable cardioverter defibrillator (ICD), an intolerance to certain sugars.

Before having surgery, tell your doctor or dentist that you are taking this medication.

Does alcohol intake affect this drug?

  • Avoid alcohol while taking amiodarone

The elderly: amiodarone should be used with caution in the elderly as it may cause slowing of the heart (bradycardia), changes in heart rhythm and thyroid problems.

Pregnancy and breastfeeding - please ensure you read the detailed information below

PREGNANCY

Amiodarone is not safe to take if you are, or are planning to become, pregnant.

It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

BREAST FEEDING

Amiodarone is not safe to take if you are breastfeeding.

It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

AMIODARONE INTERACTIONS

Before using this medicine, tell your prescriber of all the medicines you are taking including prescription medicines and medicines you have bought over the counter without a prescription. Tell your prescriber if you are taking vitamins or complementary remedies such as herbal products, as these can also interact with medicines.

If you are taking more than one medicine, these may interact with each other. Your prescriber may decide to use medicines which interact with each other if the benefit outweighs the risks. In these cases, the dose of your medicines may need to be adjusted or you may be monitored more closely.

The following medicines may interact with amiodarone:

  • Sotalol
  • Quinidine
  • Procainamide
  • Disopyramide
  • Bretylium
  • Antibiotics including erythromycin, co-trimoxazole, moxifloxacin, levofloxacin and pentamidine
  • Chlorpromazine
  • Thioridazine
  • Fluphenazine
  • Pimozide
  • Zuclopenthixol
  • Haloperidol
  • Benperidol
  • Amisulpiride
  • Sertindole
  • Lithium
  • Doxepin
  • Maprotiline
  • Tricyclic antidepressants including amitriptyline
  • Fosamprenavir
  • Indinavir
  • Nelfinavir
  • Ritonavir
  • Quinine
  • Mefloquine
  • Chloroquine
  • Quinine
  • Hydroxychloroquine
  • Halofantrine
  • Artemether/lumefantrine
  • Antihistamines including terfenadine, astemizole and mizolastine
  • Algasidase alfa and beta
  • Dolasetron
  • Grapefruit juice
  • Ciprofloxacin
  • Ofloxacin
  • Other antibiotic medicines used for infection
  • Medicines used to treat fungal infections
  • Beta-blockers such as propranolol, metoprolol
  • Calcium channel blockers such as diltiazem and verapamil
  • Medicines for constipation
  • Phenindione
  • Medicines for high cholesterol (statins)
  • Amphotericin
  • Corticosteroids
  • Dabigatran etexilate
  • Water tablets (diuretics)
  • General anaesthetics or high dose oxygen
  • Tetracosactide
  • Thyroid hormones
  • Tolteridine
  • Sulpiride
  • Phenytoin
  • Eplerenone
  • Carbamazepine
  • Acetazolamide
  • Warfarin
  • Digoxin
  • Ciclosporin
  • Tacrolimus
  • Ivabradine
  • Medicines for impotence such as sildenafil, tadalafil or vardenafil
  • Fentanyl
  • Rifampicin
  • Ergotamine
  • Ergometrine
  • Orlistat
  • Atazanivir
  • Dextromethorphan (a cough medicine)
  • Atomoxetine
  • Saquinavir
  • Midazolam
  • Flecainide
  • Bupivacaine
  • Levobupivacaine
  • Ropivacaine
  • Prilocaine
  • Lidocaine
  • St John's wort

This information does not contain all possible interactions. Therefore, tell your prescriber of all the products you are using before taking this medicine.

If you have a question or want to discuss anything about your medicine, speak to your local pharmacist.

AMIODARONE OVERDOSE

Taking too much amiodarone may cause the following: dizziness, sweating, low blood pressure, feeling faint or tired, confusion, slow or fast heartbeat, damage to the liver and being sick.

People who have taken too much amiodarone should tell a doctor or go to a hospital casualty department straight away. Take the medicine pack with you so the doctor knows what you have taken.

If you think you, or someone you care for, might have accidentally taken more than the recommended dose of amiodarone or intentional overdose is suspected, contact your local hospital, GP or if in England call 111. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.

MISSED DOSE

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

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Source: Selected from data included with permission and copyrighted by Boots UK Limited. This copyrighted material is sourced from a licensed data provider and is not for distribution, except as may be authorised by the applicable terms of use.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse events, nor should it be construed to indicate that use of a particular medicine is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any medicine, changing any diet, or discontinuing any course of treatment.

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