am-ee-OH-da-rone
BEERS REMS, High Alert
Absorption: Slowly and variably absorbed from the GI tract (35–65%). IV administration results in complete bioavailability.
Distribution: Distributed to and accumulates slowly in body tissues. Reaches high levels in fat, muscle, liver, lungs, and spleen. Crosses the placenta and enters breast milk.
Protein Binding: 96% bound to plasma proteins.
Half-Life: 13–107 days.
(suppression of ventricular arrhythmias)
| ROUTE | ONSET | PEAK | DURATION |
|---|---|---|---|
| PO | 2–3 days (up to 2–3 mo) | 3–7 hr | wk–mos |
| IV | 2 hr | 3–7 hr | unknown |
Contraindicated in:
Use Cautiously in:
CV: bradycardia, hypotension, HF, QT interval prolongation, WORSENING OF ARRHYTHMIAS
Derm: photosensitivity, blue discoloration, TOXIC EPIDERMAL NECROLYSIS (RARE)
EENT: corneal microdeposits, abnormal sense of smell, dry eyes, optic neuritis, optic neuropathy, photophobia
Endo: hypothyroidism, hyperthyroidism
GI: anorexia, constipation, nausea, vomiting, ↑liver enzymes, abdominal pain, abnormal sense of taste
GU: ↓libido, epididymitis
Neuro: ataxia, dizziness, fatigue, involuntary movement, malaise, paresthesia, peripheral neuropathy, poor coordination, tremor, confusional states, disorientation, hallucinations, headache, insomnia
Resp: ACUTE RESPIRATORY DISTRESS SYNDROME, PULMONARY FIBROSIS
Drug-drug:
Drug-Natural Products:
Ventricular Arrhythmias
Intraosseous
(Children and infants): PALS guidelines for pulseless VF/VT: 5 mg/kg as a bolus; Perfusion tachycardia: 5 mg/kg loading dose over 20–60 min (maximum of 15 mg/kg/day; unlabeled).Lab Test Considerations:
IV vasoactive medications are inherently dangerous; fatalities have occurred from medication errors involving amiodarone. Before administering, have second practitioner check original order, dose calculations, and infusion pump settings. Patients should be hospitalized and monitored closely during IV therapy and initiation of oral therapy. IV therapy should be administered only by clinicians experienced in treating life-threatening arrhythmias.
IV Administration:
NDC Code