{"id":3682,"date":"2025-03-31T18:11:47","date_gmt":"2025-03-31T18:11:47","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/amiodarone-hydrochloride-txt\/"},"modified":"2025-03-31T18:11:47","modified_gmt":"2025-03-31T18:11:47","slug":"amiodarone-hydrochloride-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/amiodarone-hydrochloride-txt\/","title":{"rendered":"Amiodarone hydrochloride.txt"},"content":{"rendered":"

Amiodarone hydrochloride<\/h1>\n

CLINICAL USE <\/H3>
\nCardiac arrhythmias
\n

DOSE IN NORMAL RENAL FUNCTION <\/H3><\/p>\n
  • Oral: 200 mg 3 times a day for 1 week, then\n

    twice a day for 1 week, then 200 mg daily
    \nmaintenance dose or minimum required
    \nto control arrhythmia<\/p>\n

  • IV: via central catheter \u2013 5 mg\/kg\n

    (maximum 1.2 g in 24 hours)<\/p>\n

  • Ventricular arrhythmias or pulseless\n

    ventricular tachycardias: 300 mg over at
    \nleast 3 minutes
    \n

    PHARMACOKINETICS <\/H3>
    \n
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    \n681.8\n<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    \n96\n<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp :
    \n<5\n<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :
    \n70\u2013140\n<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :
    \n20\u2013100 days\/
    \nUnchanged
    \n

    DOSE IN RENAL IMPAIRMENT <\/H3>
    \n

    GFR (mL\/MIN)<\/H4>
    \n
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
    \n
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
    \n
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp :
    \nDose as in normal renal function
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
    \n
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:
    \nNot dialysed. Dose as in normal renal function<\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    \nNot dialysed. Dose as in normal renal function
    \n
  • HDF\/high flux &nbsp :
    \nUnknown dialysability. Dose as in
    \nnormal renal function
    \n
  • CAV\/VVHD &nbsp &nbsp &nbsp:
    \nNot dialysed. Dose as in normal renal function
    \n

    IMPORTANT DRUG INTERACTIONS <\/H3>
    \nPotentially hazardous interactions with other drugs<\/p>\n
  • Anti-arrhythmics: additive effect and\n

    increased risk of myocardial depression;
    \nincreased risk of ventricular arrhythmias
    \nwith disopyramide \u2013 avoid; increased
    \nflecainide concentration \u2013 halve
    \nflecainide dose; increased procainamide
    \nconcentration \u2013 avoid<\/p>\n

  • Antibacterials: increased risk of\n

    ventricular arrhythmias with parenteral
    \nerythromycin, co-trimoxazole and
    \nmoxifloxacin \u2013 avoid concomitant use<\/p>\n

  • Anticoagulants: metabolism inhibited\n

    (increased anticoagulant effect)<\/p>\n

  • Antidepressants: increased risk of\n

    ventricular arrhythmias with tricyclic
    \nantidepressants \u2013 avoid concomitant use<\/p>\n

  • Anti-epileptics: phenytoin metabolism\n

    inhibited (increased plasma concentration)<\/p>\n

  • Antihistamines: increased risk of\n

    ventricular arrhythmias with mizolastine
    \n\u2013 avoid<\/p>\n

  • Antimalarials: increased risk of\n

    ventricular arrhythmias with chloroquine,
    \nhydroxychloroquine, mefloquine and
    \nquinine \u2013 avoid concomitant use; avoid
    \nconcomitant use with artemether\/
    \nlumefantrine<\/p>\n

  • Antipsychotics: increased risk\n

    of ventricular arrhythmias with
    \nantipsychotics that prolong the QT
    \ninterval; increased risk of ventricular
    \narrhythmias with amisulpride, haloperidol,
    \nphenothiazines, pimozide or sertindole \u2013
    \navoid<\/p>\n

  • Antivirals: increased risk of ventricular\n

    arrhythmias with amprenavir, nelfinavir
    \nand ritonavir \u2013 avoid concomitant use;
    \nconcentration possibly increased by
    \natazanavir; avoid with indinavir<\/p>\n

  • Atomoxetine: increased risk of ventricular\n

    arrhythmias<\/p>\n

  • Beta-blockers, diltiazem, verapamil:\n

    increased risk of bradycardia, AV block
    \nand myocardial depression; increased risk
    \nof ventricular arrhythmias with sotalol \u2013
    \navoid<\/p>\n

  • Ciclosporin: increased levels of ciclosporin\n

    possible<\/p>\n

  • Digoxin: increased plasma concentration\n

    (halve digoxin maintenance dose)<\/p>\n

  • 5HT\n

    3 antagonists: increased risk of
    \nventricular arrhythmias with dolasetron
    \n\u2013 avoid concomitant use; caution with
    \ntropisetron<\/p>\n

  • Ivabradine: increased risk of ventricular\n

    arrhythmias \u2013 avoid concomitant use<\/p>\n

  • Lipid-lowering drugs: increased risk\n

    of myopathy with simvastatin \u2013 do not
    \nexceed 20 mg of simvastatin.1<\/p>\n

  • Lithium: increased risk of ventricular\n

    arrhythmias \u2013 avoid concomitant use<\/p>\n

  • Pentamidine: increased risk of ventricular\n

    arrhythmias \u2013 avoid concomitant use<\/p>\n

  • Grapefruit juice: may increase\n

    concentration of amiodarone \u2013 avoid
    \nconcomitant use
    \n

    ADMINISTRATION <\/H3>
    \n

    Reconstition<\/H4>
    \n\u2013
    \n

    Route <\/H4><\/p>\n
  • Oral, IV via central catheter or\n

    peripherally in veins with good blood flow
    \n

    Rate of Administration <\/H4><\/p>\n
  • 20\u2013120 minutes (max 1.2 g in up to 500 mL\n

    glucose 5% in 24 hours)
    \n

    Comments<\/H4><\/p>\n
  • Add dose to 250 mL glucose 5%\n
  • Solutions containing less than 300 mg in\n

    500 mL glucose 5% should not be used, as
    \nunstable<\/p>\n

  • Minimum volumes for central use only are\n

    up to 900 mg in 48\u201350 mL. <\/p>\n

    OTHER INFORMATION <\/H4><\/p>\n
  • Amiodarone and desethylamiodarone\n

    levels can be monitored to assess
    \ncompliance<\/p>\n

  • In extreme clinical emergency, may be\n

    given by slow IV bolus using 150\u2013300 mg
    \nin 10 to 20 mL glucose 5% over a minimum
    \nof 3 minutes with close monitoring.
    \nThis should not be repeated for at least
    \n15 minutes<\/p>\n

  • Incompatible with sodium chloride 0.9%.\n
  • Rapid IV administration has been\n

    associated with anaphylactic shock, hot
    \nflushes, sweating, and nausea<\/p>\n","protected":false},"excerpt":{"rendered":"

    Amiodarone hydrochloride CLINICAL USE Cardiac arrhythmias DOSE IN NORMAL RENAL<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-3682","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3682","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=3682"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3682\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=3682"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=3682"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=3682"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}