PEBC: What You Need to Know: Amiodarone

Indication: Class III antiarrhythmic for atrial fibrillation


Dosing:

-large loading dose is required due to long half life (800 to 1600 mg daily in divided doses)

-maintenance dose is around 100 to 400 mg daily

Adverse Effects: (MANY!)

-GI upset (take with food)

-thyroid irregularities (hypo or hyperthyroidism)

-blue pigmentation of skin (after very long time)

-QT prolongation and torsades de pointes (rare, but possible)

-bradycardia

-photosensitivity (wear sunscreen)

-elevated liver enzymes

-pulmonary fibrosis (rare)

-peripheral neuropathy

-corneal deposits (regular eye exams)


Drug Interactions:

Amiodarone is an inhibitor of CYP2D6, 2C9, 3A4, pgp (dirty drug)

-Caution due to many interactions (especially digoxin and warfarin)

-Increased bradycardia with beta blockers and calcium channel blockers

-QT prolongation risk when combined with other QT like drugs (ciprofloxacin, escitalopram)

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