Amiodarone
Amiodarone
(Trangorex, Cordarone)
Description
Amiodarone (am-ee-OH-da-rone ) belongs to the
group of medicines known as antiarrhythmics. It is used to correct irregular
heartbeats to a normal rhythm.
Amiodarone produces its helpful effects by slowing nerve impulses in the
heart and acting directly on the heart tissues.
Before Using This Medicine
In deciding to use a medicine, the risks of
taking the medicine must be weighed against the good it will do. This is a
decision you and your doctor will make. For amiodarone, the following should
be considered:
Allergies
Tell your doctor if you have ever had any
unusual or allergic reaction to amiodarone. Also tell your health care
professional if you are allergic to any other substances, such as foods,
preservatives, or dyes.
Pregnancy
Amiodarone has been shown to cause thyroid
problems in babies whose mothers took amiodarone when pregnant. In addition,
there is concern that amiodarone could cause slow heartbeat in the newborn.
However, this medicine may be needed in serious situations that threaten the
mother's life. Be sure you have discussed this with your doctor before
taking this medicine.
Breast-feeding
Although amiodarone passes into breast milk,
it has not been shown to cause problems in nursing babies. However,
amiodarone has been shown to cause growth problems in rats. It may be
necessary for you to stop breast-feeding during treatment. Be sure you have
discussed the risks and benefits of the medicine with your doctor.
Children
Amiodarone can cause serious side effects in
any patient. Therefore, it is especially important that you discuss with the
child's doctor the good that this medicine may do as well as the risks of
using it.
Older adults
Elderly patients may be more likely to get
thyroid problems with this medicine. Also, difficulty in walking and
numbness, tingling, trembling, or weakness in hands or feet are more likely
to occur in the elderly.
Other medicines
Although certain medicines should not be used
together at all, in other cases two different medicines may be used together
even if an interaction might occur. In these cases, your doctor may want to
change the dose, or other precautions may be necessary. When you are taking
amiodarone, it is especially important that your health care professional
know if you are taking any of the following:
• Anticoagulants (blood thinners) or
• Other heart medicine or
• Phenytoin (e.g., Dilantin)—Effects may be increased
Other medical problems—The presence of other medical problems may affect the
use of amiodarone. Make sure you tell your doctor if you have any other
medical problems, especially:
• Hepatitis, acute— Risk of adverse effects is increased.
• Liver disease—Effects of amiodarone may be increased because of slower
removal from the body
• Thyroid problems—Risk of overactive or underactive thyroid is increased
Proper Use of This Medicine
Take amiodarone exactly as directed by your
doctor even though you may feel well. Do not take more medicine than ordered
and do not miss any doses.
Dosing
The dose of amiodarone will be different for
different patients. Follow your doctor's orders or the directions on the
label. The following information includes only the average doses of
amiodarone. If your dose is different, do not change it unless your doctor
tells you to do so:
• For oral dosage form (tablets):
• For treatment of ventricular arrhythmias:
Adults
At first, 800 to 1600 milligrams (mg) per day
taken in divided doses. Then, 600 to 800 mg per day for one month. Then, 400
mg per day.
Children
Dose is based on body weight and must be
determined by your doctor. The dose for the first ten days is usually 10 mg
per kilogram (4.55 mg per pound) of body weight per day. Then, the dose is
decreased to 5 mg per kilogram (2.27 mg per pound) of body weight per day.
After several weeks, the dose is then decreased to 2.5 mg per kilogram (1.14
mg per pound) of body weight per day.
• For injection dosage form:
• For treatment of ventricular arrhythmias
• Adults—At first, the dose is 150 mg injected into a vein for ten minutes,
followed by a dose of 360 mg injected into a vein for six hours, followed by
a dose of 540 mg injected into a vein for eighteen hours. After the first
twenty-four hours of therapy, the dose is 720 mg injected into a vein every
twenty-four hours; this dose may be continued for as long as three weeks.
• Children—Use is not recommended.
Missed dose
If you miss a dose of this medicine, do not
take the missed dose at all and do not double the next one. Instead, go back
to your regular dosing schedule. If you miss two or more doses in a row,
check with your doctor.
Storage
To store this medicine:
• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp
places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that
any discarded medicine is out of the reach of children.
Precautions While Using This Medicine
It is important that your doctor check your
progress at regular visits to make sure the medicine is working properly.
This will allow for changes to be made in the amount of medicine you are
taking, if necessary.
Your doctor may want you to carry a medical identification card or bracelet
stating that you are taking this medicine.
Before having any kind of surgery (including
dental surgery) or emergency treatment, tell the medical doctor or dentist
in charge that you are taking this medicine.
Amiodarone increases the sensitivity of your
skin to sunlight; too much exposure could cause a serious sunburn. Your skin
may continue to be sensitive to sunlight for several months after treatment
with this medicine is stopped. A sunburn can occur even through window glass
or thin cotton clothing. If you must go out in the sunlight, cover your skin
and wear a wide-brimmed hat. A product applied to the skin to prevent
sunburn should also be used. In case of a severe sunburn, check with your
doctor.
After you have taken this medicine for a long
time, it may cause a blue-gray color to appear on your skin, especially in
areas exposed to the sun, such as your face, neck, and arms. This color will
usually fade after treatment with amiodarone has ended, although it may take
several months. However, check with your doctor if this effect occurs.
Check with your doctor if you notice any
changes in your vision, such as a decrease in peripheral vision or a
decrease in the clarity of the objects that you see.
Side Effects of This Medicine
Along with its needed effects, a medicine may
cause some unwanted effects. Although not all of these side effects may
occur, if they do occur they may need medical attention. Also, some side
effects may not appear until several weeks or months, or even years, after
you start taking amiodarone.
Check with your doctor immediately if any of the following side effects
occur:
• More common
• Cough; painful breathing; shortness of breath
Check with your doctor as soon as possible if any of the following side
effects occur:
• More common
• Dizziness, lightheadedness, or fainting; fever (slight); numbness or
tingling in fingers or toes; sensitivity of skin to sunlight; trembling or
shaking of hands; trouble in walking; unusual and uncontrolled movements of
the body; weakness of arms or legs
• Less common
• Blue-gray coloring of skin on face, neck, and arms; blurred vision or
blue-green halos seen around objects; coldness; dry eyes; dry, puffy skin;
fast or irregular heartbeat; nervousness; pain and swelling in scrotum ;
sensitivity of eyes to light; sensitivity to heat; slow heartbeat; sweating;
swelling of feet or lower legs; trouble in sleeping; unusual tiredness;
weight gain or loss
• Rare
• Skin rash; yellow eyes or skin
Other side effects may occur that usually do not need medical attention.
These side effects may go away during treatment as your body adjusts to the
medicine. However, check with your doctor if any of the following side
effects continue or are bothersome:
• More common
• Constipation; headache; loss of appetite; nausea and vomiting
• Less common
• Bitter or metallic taste; decreased sexual ability in males; decrease in
sexual interest ; dizziness; flushing of face
After you stop using this medicine, your body may need time to adjust. The
length of time this takes depends on the amount of medicine you were using
and how long you used it. During this period of time check with your doctor
if you notice any of the following side effects:
• Cough; fever (slight); painful breathing; shortness of breath
Other side effects not listed above may also occur in some patients. If you
notice any other effects, check with your doctor.
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