Amiodarone tablets do not have to be taken with food. Do not drink grapefruit juice while taking this medicine. This is because drinking grapefruit juice while taking Amiodarone Tablets can increase your chance of getting side effects. Limit the amount of alcohol you drink whilst taking this medicine. This is because drinking alcohol while taking this medicine will increase the chance of you having problems with your liver.

Talk to your doctor or pharmacist about the amount of alcohol you can drink. Protect your skin from sunlight: Keep out of direct sunlight while taking this medicine and for a few months after you have finished taking it.

This is because your skin will become much more sensitive to the sun and may burn, tingle or severely blister if you do not take the following precautions: Ask your doctor or pharmacist for advice before taking any medicine if you are pregnant or breast-feeding. Driving and using machines: This product may cause vertigo or blurred vision, so do not drive or operate machinery.

Important information about some of the ingredients in Amiodarone Tablets: If you have been told by your doctor that you cannot tolerate or digest some sugars have an intolerance to some sugars , talk to your doctor before taking this medicine.

Amiodarone Tablets contain If needed, oral therapy may be initiated concomitantly Elderly: As with all patients, it is important that the minimum effective dose is used. Whilst there is no evidence that dosage requirements are different for this group of patients, they may be more susceptible to bradycardia and conduction defects if too high a dose is employed.

Particular attention should be paid to monitoring thyroid function see sections 4. In patients with severe conduction disturbances high grade AV block, bifascicular or trifascicular block or sinus node disease, Amiodarone should be used only in conjunction with a pacemaker.

Patients with Brugada syndrome. Too high a dosage may lead to severe bradycardia and to conduction disturbances with the appearance of an idioventricular rhythm, particularly in elderly patients or during digitalis therapy. In these circumstances, amiodarone treatment should be withdrawn. If necessary beta-adrenostimulants or glucagon may be given. Caution should be exercised in patients with hypotension and decompensated cardiomyopathy.

Amiodarone induces ECG changes: QT interval lengthening corresponding to prolonged repolarisation with the possible development of U and deformed T-waves; these changes are evidence of its pharmacological action and do not reflect toxicity.

Although there have been literature reports on the potentiation of hepatic adverse effects of alcohol, patients should be advised to moderate their alcohol intake while being treated with amiodarone. Before surgery, the anaesthetist should be informed that the patient is being treated with amiodarone see section 4. Increased plasma levels of flecainide have been reported with co-administration of amiodarone. The flecainide dose should be reduced accordingly and the patient closely monitored see section 4.

Benzyl alcohol may cause toxic reactions and allergic reactions in infants and children up to 3 years old. Amiodarone raises the plasma concentrations of highly protein bound drugs, for example oral anticoagulants and phenytoin. The dose of warfarin should be reduced accordingly.

More frequent monitoring of prothrombin time both during and after amiodarone treatment is recommended. Phenytoin dosage should be reduced if signs of overdosage appear and plasma levels may be measured. Administration of amiodarone injection to a patient already receiving digoxin will bring about an increase in the plasma digoxin concentration and thus precipitate symptoms and signs associated with high digoxin levels.

Monitoring is recommended and digoxin dosage usually has to be reduced. A synergistic effect on heart rate and atrioventricular conduction is also possible. Combined therapy with the following drugs which prolong the QT interval is contra-indicated see section 4. Stimulant laxatives may cause hypokalaemia thus increasing the risk of torsades de pointes; other types of laxatives should be used.

In cases of hypokalaemia, corrective action should be taken and QT interval monitored. In case of torsades de pointes, antiarrhythmic agents should not be given; pacing may be instituted and IV magnesium may be used.

Caution is advised in patients undergoing general anaesthesia, or receiving high dose oxygen therapy. Potentially severe complications have been reported in patients taking amiodarone while undergoing general anaesthesia: A few cases of adult respiratory distress syndrome, most often in the period immediately after surgery, have been observed.

A possible interaction with a high oxygen concentration may be implicated. The anaesthetist should be informed that the patient is taking amiodarone. This inhibition can result in unexpectedly high plasma levels of other drugs which are metabolized by CYP3A4 enzymes. Examples of other drugs known to be metabolized by CYP3A4 are: Fentanyl, lidocaine, macrolide antibiotics clarithromycin , midazolam, sildenafil, ergotamine.

Since amiodarone is a substrate for CYP3A4, drugs or substances that inhibit these isoenzymes may decrease the metabolism and increase the serum concentration of amiodarone. Known inhibitors of CYP3A4 like protease inhibitors indinavir , histamine H2 antagonists cimetidine , macrolide antibiotics clarithromycin , azol antifungals ketoconazole, itraconazole can increase plasma levels of amiodarone.

When changing from intravenous amiodarone to oral amiodarone the consumption of grapefruit juice should be avoided since it can increase the plasma levels of amiodarone.

Drugs and substances that stimulate the synthesis of CYP3A4 enzyme inducers may lead to low amiodarone serum levels and potential decrease in efficacy. Reported examples of this interaction include antibiotics rifampicin. The use of St. John's Wort Hypericum perforatum in patients receiving amiodarone could result in reduced amiodarone levels.

This inhibition can result in unexpectedly high plasma levels of other drugs which are metabolised by those CYP enzymes like flecainide, dextromethorphan, metoprolol. There is insufficient data on the use of Amiodarone during pregnancy in humans to judge any possible toxicity. Major Case reports indicate that QT prolongation and torsade de pointes TdP can occur during donepezil therapy.

Donepezil is considered a drug with a known risk of TdP. Amiodarone has a possible risk for QT prolongation and TdP and should be used cautiously and with close monitoring with donepezil.

In addition, amiodarone inhibits CYP2D6, one of the isoenzymes involved in the metabolism of donepezil. In theory, co-administration of amiodarone and donepezil could increase donepezil concentrations, potentially resulting in dose-related toxicity. However, the clinical effect of such an interaction on the response to donepezil has not been determined.

Moderate Amiodarone inhibits CYP and may inhibit the hydroxylation of doxercalciferol, thereby decreasing the formation of the active metabolite and thus, decreasing efficacy. Patients should be monitored for a decrease in efficacy if amiodarone is coadministered with doxercalciferol. Major Avoid the concomitant use of doxorubicin and amiodarone; use of these drugs together may increase doxorubicin concentrations and increase the risk of doxorubicin-induced toxicity. Major Use caution if coadministration of dronabinol with amiodarone is necessary, and monitor for an increase in dronabinol-related adverse reactions e.

Concomitant use may result in elevated plasma concentrations of dronabinol. Severe Dronedarone administration is associated with a dose-related increase in the QTc interval. The increase in QTc is approximately 10 milliseconds at doses of mg twice daily the FDA-approved dose and up to 25 milliseconds at doses of mg twice daily. Although there are no studies examining the effects of dronedarone in patients receiving other QT prolonging drugs, coadministration of such drugs may result in additive QT prolongation.

The concomitant use of dronedarone with other drugs that prolong the QTc may induce Torsade de Pointes TdP and is contraindicated. Major Droperidol should be administered with extreme caution to patients receiving other agents that may prolong the QT interval.

Droperidol administration is associated with an established risk for QT prolongation and torsades de pointes TdP. In December , the FDA issued a black box warning regarding the use of droperidol and its association with QT prolongation and potential for cardiac arrhythmias based on post-marketing surveillance data.

According to the revised labeling for droperidol, any drug known to have potential to prolong the QT interval should not be coadministered with droperidol. Drospirenone; Ethinyl Estradiol; Levomefolate: Moderate Monitor for adverse effects associated with increased exposure to duloxetine if amiodarone is coadministered. Orthostatic hypotension and syncope have been reported during duloxetine administration.

The concurrent administration of amiodarone and duloxetine may increase the risk of hypotension; monitor blood pressure if the combination is necessary. The clearance of dutasteride may be reduced when co-administered with CYP3A4 inhibitors, such as amiodarone.

Major Plasma concentrations of tamsulosin may be increased with concomitant use of amiodarone. In clinical evaluation, concomitant treatment with a strong CYP3A4 inhibitor resulted in significant increases in tamsulosin exposure.

Moderate Coadministration of edoxaban and amiodarone may result in increased concentrations of edoxaban. Edoxaban is a P-glycoprotein P-gp substrate and amiodarone is a P-gp inhibitor. Increased concentrations of edoxaban may occur during concomitant use of amiodarone; monitor for increased adverse effects of edoxaban. Dosage reduction may be considered for patients being treated for deep venous thrombosis DVT or pulmonary embolism. Major If possible, avoid coadministration of efavirenz and amiodarone, as use of these medications together may increase the risk for QT prolongation and torsade de pointes TdP.

QT prolongation has been observed with use of efavirenz. Although data are limited, the manufacturer of efavirenz recommends an alternative antiretroviral be considered for patients receiving medications with a known risk for TdP. In addition, efavirenz induces CYP3A4 and may decrease serum concentrations of drugs metabolized by this enzyme, such as amiodarone. It would be prudent to monitor for changes in amiodarone efficacy. Moderate Administering elbasvir; grazoprevir with amiodarone may cause the plasma concentrations of all three drugs to increase; thereby increasing the potential for adverse effects i.

Amiodarone is a substrate and moderate inhibitor of CYP3A. If these drugs are used together, closely monitor for signs of hepatotoxicity. Moderate Use caution when coadministering eletriptan and amiodarone. Coadministration may cause an increase in systemic concentrations of eletriptan.

Major Coadministration of amiodarone and eliglustat is not recommended. Amiodarone-mediated inhibition of CYP2D6 and CYP3A in a patient receiving eliglustat may result in unexpectedly high plasma concentrations of eliglustat, further increasing the risk of serious adverse events e.

Emtricitabine; Rilpivirine; Tenofovir alafenamide: Major The concomitant use of amiodarone and rilpivirine should only be done after careful assessment of risks versus benefits. If possible, avoid coadministration. Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate: Emtricitabine; Tenofovir disoproxil fumarate: Major Combination therapy with encainide and amiodarone has been reported to significantly increase the risk of proarrhythmias, necessitating close monitoring.

Moderate Monitor for decreased efficacy of amiodarone if coadministration with enzalutamide is necessary. Coadministration may decrease amiodarone plasma concentrations. Major The concomitant use of amiodarone and other drugs known to prolong the QT interval should be dont only after careful assessment of risks versus benefits, especially when the coadministered agent might decrease the metabolism of amiodarone.

Acute cardiotoxicity can occur during administration of daunorubicin, doxorubicin, epirubicin, and idarubicin; cumulative, dose-dependent cardiomyopathy may also occur.

Amiodarone inhibits the hepatic CYP3A4 isoenzyme and therefore may increase the serum concentrations of eplerenone.

Increased eplerenone concentrations may lead to a risk of developing hyperkalemia and hypotension. If these medications are given concurrently in post-myocardial infarction patients with heart failure, do not exceed an eplerenone dose of 25 mg PO once daily.

If these medications are given concurrently, and eplerenone is used for hypertension, initiate eplerenone at 25 mg PO once daily. The dose may be increased to a maximum of 25 mg PO twice daily for inadequate blood pressure response. Major Coadministration of certain ergot alkaloids with inhibitors of CYP3A4, such as amiodarone, may potentially increase the risk of ergot toxicity e.

Coadministration should be done cautiously until further data are available regarding the combination of these drugs with ergonovine.

Eribulin has been associated with QT prolongation. If eribulin and amiodarone must be coadministered, ECG monitoring is recommended; closely monitor the patient for QT interval prolongation.

Major Avoid the coadministration of erlotinib with amiodarone due to the risk of increased erlotinib-related adverse reactions; if concomitant use is unavoidable and severe reactions occur, reduce the dose of erlotinib by 50 mg decrements.

In addition to potential pharmacokinetic interactions, erythromycin may cause QT prolongation and exhibit additive electrophysiologic effects with Class III antiarrhythmics. Concurrent use of erythromycin with amiodarone should be avoided. In addition, erythromycin may theoretically increase plasma concentrations of amiodarone via inhibition of CYP3A4. Higher antiarrhythmic plasma concentrations increases the potential risk of QT prolongation, TdP or other proarrhythmias.

Major Escitalopram has been associated with QT prolongation. Coadministration with other drugs that have a possible risk for QT prolongation and torsade de pointes TdP , such as amiodarone, should be done with caution and close monitoring. Coadministration of CYP3A4 substrates, such as amiodarone, may result in decreased serum concentrations of the substrate. Monitor for decreased efficacy of amiodarone if coadministered with eslicarbazepine.

Moderate Monitor for eszopiclone adverse effects, such as CNS depression, during coadministration with amiodarone. A decreased dose of eszopiclone may be warranted. The plasma concentrations of eszopiclone may be elevated when administered concurrently with amiodarone. Major Monitor serum electrolytes if coadministration of ethacrynic acid and amiodarone is necessary. Ethacrynic acid therapy may cause electrolyte abnormalities i.

Ethinyl Estradiol; Ethynodiol Diacetate: Ethinyl Estradiol; Norethindrone Acetate: Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate: Ethinyl Estradiol; Norethindrone; Ferrous fumarate: For example, when fentanyl was administered to patients receiving amiodarone, the incidence of bradycardia and other adverse cardiovascular effects was much higher than in patients not on amiodarone who received fentanyl.

Major Monitor for an increased incidence of etoposide-related adverse effects if used concomitantly with amiodarone. Coadministration may cause accumulation of etoposide and decreased metabolism, resulting in increased etoposide concentrations. Major Etravirine is an inducer of CYP3A4; amiodarone concentrations may be decreased with coadministration. Coadminister these drugs with caution. It is recommended to monitor amiodarone concentrations when possible.

Moderate Use caution if coadministration of amiodarone and everolimus is necessary, due to a possible increase in systemic exposure to everolimus. Monitor everolimus whole blood trough concentrations closely; everolimus dose reductions may be required. In addition, amiodarone is a substrate of CYP3A4. The effect of everolimus on amiodarone pharmacokinetics has not been established; however, pharmacokinetic studies showed no significant impact of the coadministration of everolimus with another CYP3A4 and P-gp substrate.

Carefully weigh the benefits of combined use of amiodarone and simvastatin against the potential risks. Amiodarone increases the simvastatin exposure by approximately 2-fold. Ezogabine has been associated with QT prolongation. If coadministration is necessary, the manufacturer of ezogabine recommends caution during concurrent use with amiodarone. When fentanyl is administered to patients receiving amiodarone, the incidence of bradycardia and other adverse cardiovascular effects was much higher than in patients not on amiodarone who received fentanyl.

Due to the extremely long elimination half-life of amiodarone, fentanyl should be used cautiously in patients who are receiving amiodarone or who have received amiodarone in the preceding month. Moderate Fesoterodine is rapidly hydrolyzed to its active metabolite, 5-hydroxymethyltolterodine, which is metabolized via hepatic CYP3A4 and 2D6. Amiodarone can inhibit hepatic CYP2D6 and CYP3A4 isoenzymes, which may impair both CYP metabolic pathways of 5-hydroxymethyltolterodine and result in elevated plasma concentrations of 5-hydroxymethyltolterodine and an increased risk for adverse reactions.

According to the manufacturer, no dosage adjustments of fesoterodine are recommended during concurrent use of moderate CYP3A4 inhibitors. Fingolimod initiation results in decreased heart rate, and Class III antiarrhythmic drugs have been associated with cases of torsades de pointes in patients with bradycardia.

Major Flecainide has been used in combination with amiodarone in specialized settings to treat refractory arrhythmias. Close monitoring of therapeutic response is warranted for patients receiving combination therapy, including serum drug concentration monitoring. Amiodarone inhibits the hepatic metabolism of flecainide via CYP2D6 inhibition. When amiodarone is added to flecainide therapy, plasma flecainide levels may increase two-fold or more in some patients, if flecainide dosage is not reduced.

Serum drug concentration monitoring is strongly recommended to guide dosage with such combination therapy. Coadministration of amiodarone with drugs that prolong the QT interval should be done with a careful assessment of risks versus benefits. Although rare, cases of QT prolongation and torsade de pointes TdP have been reported during flecainide therapy; causality has not been established.

Based on theoretical considerations, the manufacturer recommends allowing at least 2 to 4 plasma half-lives to elapse following flecainide discontinuation before switching to another antiarrhythmic drug.

Severe The concomitant use of flibanserin and moderate CYP3A4 inhibitors, such as amiodarone, is contraindicated. Moderate CYP3A4 inhibitors can increase flibanserin concentrations, which can cause severe hypotension and syncope.

If initiating flibanserin following use of a moderate CYP3A4 inhibitor, start flibanserin at least 2 weeks after the last dose of the CYP3A4 inhibitor. If initiating a moderate CYP3A4 inhibitor following flibanserin use, start the moderate CYP3A4 inhibitor at least 2 days after the last dose of flibanserin. Severe Fluconazole has been associated with QT prolongation and rare cases of torsades de pointes TdP.

The concurrent use of fluconazole and other drugs that prolong the QT and are CYP3A4 substrates, such as amiodarone, is contraindicated due to the risk of life-threatening arrhythmias such as TdP. Coadministration of fluconazole with amiodarone may result in an elevated plasma concentration of the interacting drug, causing an increased risk for adverse events, such as QT prolongation.

Major Because QT prolongation and torsade de pointes TdP have been reported in patients treated with fluoxetine, the manufacturer recommends caution when using fluoxetine with other drugs that prolong the QT interval.

Drugs with a possible risk for QT prolongation and TdP include amiodarone. In addition, amiodarone inhibits CYP2D6 and may theoretically increase concentrations of other drugs metabolized by this enzyme, such as fluoxetine.

Major The concomitant use of amiodarone and other drugs known to prolong the QT interval, such as olanzapine, should only be done after careful assessment of risks versus benefits. If possible, avoid coadministration of amiodarone and olanzapine. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances. Minor The concomitant use of amiodarone and other drugs known to prolong the QT interval should only be done after careful assessment of risks versus benefits.

Drugs with a possible risk for QT prolongation include fluphenazine. Moderate Amiodarone is a CYP3A4 inhibitor and may reduce the metabolism of flurazepam and increase the potential for benzodiazepine toxicity. Minor Amiodarone inhibits cytochrome P 2C9. Caution is recommended when administering amiodarone with other CYP2C9 substrates, such as flurbiprofen, that have a narrow therapeutic range or where large increase in concentrations may be associated with adverse reactions.

Moderate In theory, concurrent use CYP2C9 inhibitors, such as amiodarone, and fluvastatin, a CYP2C9 substrate, may result in reduced metabolism of fluvastatin and potential for toxicity, including myopathy and rhabdomyolysis.

Major Due to the risk of QT prolongation and torsade de pointes TdP , avoid coadministration of amiodarone and fluvoxamine if possible. QT prolongation and TdP has been reported during fluvoxamine postmarketing use. Moderate The incidence of marijuana associated adverse effects may change following coadministration with amiodarone.

Major Extreme caution is advised when administering fosamprenavir concurrently with amiodarone. If these drugs must be used together, therapeutic monitoring of amiodarone concentrations is recommended.

Taking these drug together may cause the plasma concentrations of fosamprenavir and amiodarone to be altered. Amiodarone is a substrate and inhibitor of CYP3A4; amprenavir the active metabolite of fosamprenavir if a potent inhibitor, moderate inducer and substrate of CYP3A4. In addition, fosamprenavir is a substrate for the drug transporter P-glycoprotein P-gp ; amiodarone is a P-gp inhibitor. Major When possible, avoid concurrent use of foscarnet with other drugs known to prolong the QT interval, such as amiodarone.

Foscarnet has been associated with postmarketing reports of both QT prolongation and torsade de pointes TdP.

If these drugs are administered together, obtain an electrocardiogram and electrolyte concentrations before and periodically during treatment. Major Monitor serum electrolytes if coadministration of furosemide and amiodarone is necessary.

Furosemide therapy may cause electrolyte abnormalities i. Major Monitor for an increased incidence of gefitinib-related adverse effects if gefitinib and amiodarone are used concomitantly. Coadministration may decrease the metabolism of gefitinib and increase gefitinib concentrations. In patients with poor CYP2D6 metabolism, the mean exposure to gefitinib was 2-fold higher when compared to extensive metabolizers; the contribution of drugs that inhibit CYP2D6 on gefitinib exposure has not been evaluated.

Major According to the manufacturer, gemifloxacin should be avoided in patients receiving Class III antiarrhythmics such as amiodarone. Gemifloxacin may prolong the QT interval in some patients. The maximal change in the QTc interval occurs approximately 5 to 10 hours following oral administration of gemifloxacin. The likelihood of QTc prolongation may increase with increasing dose of the drug; therefore, the recommended dose should not be exceeded especially in patients with renal or hepatic impairment where the Cmax and AUC are slightly higher.

Major Avoid coadministration of gemtuzumab ozogamicin with amiodarone due to the potential for additive QT interval prolongation and risk of torsade de pointes TdP. If coadministration is unavoidable, obtain an ECG and serum electrolytes prior to the start of and as needed during treatment.

Although QT interval prolongation has not been reported with gemtuzumab, it has been reported with other drugs that contain calicheamicin. Minor In vitro studies have demonstrated the positive inotropic effects of ginger, Zingiber officinale. It is theoretically possible that ginger could affect the action of antiarrhythmics, however, no human data are available.

Moderate Caution is advised with the coadministration of glecaprevir and amiodarone as coadministration may increase serum concentrations of glecaprevir and increase the risk of adverse effects.

Glecaprevir is a substrate of P-glycoprotein P-gp ; amiodarone is a P-gp inhibitor. Moderate Caution is advised with the coadministration of pibrentasvir and amiodarone as coadministration may increase serum concentrations of pibrentasvir and increase the risk of adverse effects. Pibrentasvir is a substrate of P-glycoprotein P-gp ; amiodarone is an inhibitor of P-gp.

Major Amiodarone should be used cautiously and with close monitoring with goserelin. Androgen deprivation therapy e. Major Granisetron has been associated with QT prolongation. Major Grapefruit juice has been shown to increase amiodarone peak serum concentrations and AUC when a single dose of amiodarone was administered orally.

No change in ECG or arterial blood pressure measurements were identified in this single dose study; however, the impact on chronic dosing of amiodarone was not evaluated. To prevent potential drug accumulation, it would be prudent to avoid taking oral amiodarone with grapefruit juice. Major Amiodarone may significantly increase guanfacine plasma concentrations.

FDA-approved labeling for extended-release ER guanfacine recommends that, if these agents are taken together, the guanfacine dosage should be decreased to half of the recommended dose. Specific recommendations for immediate-release IR guanfacine are not available. Monitor patients closely for alpha-adrenergic effects including hypotension, drowsiness, lethargy, and bradycardia. Upon amiodarone discontinuation, the guanfacine ER dosage should be increased back to the recommended dose. Severe Halofantrine should be avoided in patients receiving drugs which may induce QT prolongation; these drugs include class III antiarrhythmics.

Major QT prolongation and torsade de pointes TdP have been observed during haloperidol treatment. Excessive doses particularly in the overdose setting or IV administration of haloperidol may be associated with a higher risk of QT prolongation. According to the manufacturer of haloperidol, caution is advisable when prescribing the drug concurrently with medications known to prolong the QT interval.

Mild to moderate increases in haloperidol plasma concentrations have been reported during concurrent use of haloperidol and inhibitors of CYP3A4 or CYP2D6. Therefore, it is advisable to closely monitor for adverse events when haloperidol is co-administered with drugs that inhibit CYP3A4 and CYP2D6 and prolong the QT interval, such as amiodarone.

Major It would be prudent to avoid use of Hawthorn, Crataegus laevigata also known as C. Following hawthorn administration to guinea pigs, the cardiac action potential duration is increased and the refractory period is prolonged.

Hawthorn may also lower peripheral vascular resistance. Hawthorn thus has effects similar to the class III antiarrhythmics and would theoretically interact with drugs with similar cardiac electrophysiology e.

Patients should be advised to only use hawthorn with these antiarrhythmic agents after discussion with their prescriber. If co-use is advised, patients should receive periodic blood pressure and heart rate monitoring. Major Concomitant administration of amiodarone and phenytoin or fosphenytoin may result in phenytoin toxicity, secondary to a two- or three-fold increase in total, steady-state serum phenytoin concentrations likely due to a amiodarone-induced decrease in phenytoin metabolism.

In addition, reduced amiodarone serum concentrations may occur during phenytoin coadministration. A similar interaction may occur with ethotoin. Close monitoring for symptoms of hydantoin anticonvulsant toxicity including nystagmus, lethargy and ataxia; and evaluation of serum concentrations with appropriate dosage reduction as necessary, is essential in patients receiving these medications. Minor Coadministration of losartan with amiodarone may result in increased exposure to losartan but decreased concentrations of the active metabolite.

Because beta-blockers have similar effects, concomitant administration of beta-blockers including metoprolol with amiodarone may cause additive electrophysiologic effects slow sinus rate or worsen AV block , resulting in symptomatic bradycardia, sinus arrest, and atrioventricular block. Caution is advised as metoprolol in combination with amiodarone has resulted in severe sinus bradycardia.

Because beta-blockers have similar effects, concomitant administration of beta-blockers including propanolol with amiodarone may cause additive electrophysiologic effects slow sinus rate or worsen AV block , resulting in symptomatic bradycardia, sinus arrest, and atrioventricular block. Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine: Major Avoid coadministration of hydroxychloroquine and amiodarone.

Hydroxychloroquine increases the QT interval and should not be administered with other drugs known to prolong the QT interval. Ventricular arrhythmias and torsade de pointes TdP have been reported with the use of hydroxychloroquine. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with hydroxyzine include amiodarone.

Severe Amiodarone should not be administered concomitantly during the first four hours post-infusion of ibutilide, due to the potential for additive Class III antiarrhythmic effects. In addition, both ibutilide and amiodarone are associated with a risk of QT prolongation and torsades de pointes TdP.

Major The concomitant use of amiodarone and other drugs known to prolong the QT interval, such as iloperidone, should only be done after careful assessment of risks versus benefits. Iloperidone has been associated with QT prolongation; however, torsade de pointes TdP has not been reported. Major Any agent that inhibits cytochrome P CYP 3A4 may decrease the metabolism of imatinib and increase imatinib concentrations leading to an increased incidence of adverse reactions.

Major Indapamide may induce hypokalemia, increasing the potential for proarrhythmic effects e. Potassium levels should be within the normal range prior and during administration of these agents. In the absence of electrolyte imbalances, these agents can be used together safely.

Severe Coadministration of indinavir and amiodarone is contraindicated due to the potential for serious or life-threatening reactions, such as cardiac arrhythmias. Indinavir is an inhibitor of CYP3A4 and increased plasma concentrations of drugs extensively metabolized by this enzyme, such as amiodarone, should be expected with concurrent use. Caution is recommended when administering amiodarone with CYP2C9 substrates including indomethacin.

The metabolism of indomethacin may be decreased. Major Avoid coadministration of inotuzumab ozogamicin with amiodarone due to the potential for additive QT interval prolongation and risk of torsade de pointes TdP. If coadministration is unavoidable, obtain an ECG and serum electrolytes prior to the start of treatment, after treatment initiation, and periodically during treatment.

Inotuzumab has been associated with QT interval prolongation. Major When injected directly into coronary arteries, contrast media can cause bradycardia and QT interval prolongation; these reactions tend to be less common with nonionic low-osmolar contrast media. No significant change in the QTc interval was seen in non-amiodarone treated control patients.

Until more data are available, clinicians should closely monitor patients taking amiodarone during cardiac catheterization with radiopaque contrast agents; EKG monitoring during intra-coronary artery injection of radiopaque contrast agents is recommended. Moderate Use caution if irinotecan liposomal is coadministered with amiodarone, a CYP3A4 inhibitor, due to increased risk of irinotecan-related toxicity. The metabolism of liposomal irinotecan has not been evaluated; however, coadministration of ketoconazole, a strong CYP3A4 and UGT1A1 inhibitor, with non-liposomal irinotecan HCl resulted in increased exposure to both irinotecan and its active metabolite, SN Coadministration may result in increased irinotecan exposure.

Use caution if concomitant use is necessary and monitor for increased irinotecan side effects, including diarrhea, nausea, vomiting, and myelosuppression.

Amiodarone HCl Injection

Reported examples of this interaction include antibiotics rifampicin. Due to the presence of benzyl alcohol, Cordarone X Intravenous administration is contraindicated in newborns or premature neonates, infants and children up to 3 years old. This is because drinking grapefruit 150mg while taking Amiodarone Tablets can increase your chance of getting side effects. Follow your doctor's 150mg carefully. Intravenous amiodarone does not need to be protected from light during administration. Routine monitoring of liver function tests is therefore advised. These may be serious side effects of Ampul X In case of torsades de pointes, antiarrhythmic agents should not be given; pacing may be instituted and IV magnesium may be used, cordarone 150mg 6 ampul. Ask your doctor or pharmacist for advice before taking any medicine if you are pregnant or breast-feeding. Amiodarone Side Effects in Detail - Drugs. Drugs lowering heart rate, causing automaticity or conduction disorders Combined therapy cordarone the following drugs is not recommended: Nauseavomitingconstipationloss of appetite, shaking, or tiredness may occur. A possible interaction with a high oxygen concentration may be implicated. Therapy cordarone then continued with mg two times a day for ampul further week

Adenosine Administration

Amiodarone Hydrochloride 50 mg/ml Concentrate for Solution for Injection/Infusion

Clinical and biological signs of chronic liver disorders due to oral amiodarone may be minimal hepatomegaly, transaminases, increased cordarone to 5 times the normal range and reversible after treatment withdrawal, cordarone 150mg 6 ampul, however fatal cases have been reported. How should I keep amiodarone stored? Changeover from Intravenous to Oral therapy: Concurrent use may increase systemic exposure to alfuzosin and further increase the risk for QT prolongation. Since arrhythmia breakthroughs may accompany Amiodarone HCl-induced 150mg, aggressive medical treatment is indicated, cordarone 150mg 6 ampul, including, if possible, dose reduction or withdrawal of Amiodarone HCl. This belongs to a group of medicines called anti-arrhythmics. Minor Monitor patients for hypoglycemia if saxagliptin and amiodarone are used together. Examples of other drugs known ampul be metabolized by CYP3A4 are: Clopidogrel, an inactive thienopyridine prodrug, is metabolized in the cordarone by CYP3A4 to an ampul metabolite. Droperidol administration is associated with an 150mg risk for QT prolongation and torsades de pointes TdP. Major According to the manufacturer, gemifloxacin should be avoided in 150mg receiving Class Cordarone antiarrhythmics such as amiodarone. Alternative therapies that do not inhibit the CYP3A4 isoenzyme should be considered. Close perioperative monitoring is recommended in patients ampul general anesthesia who are on amiodarone therapy as they may be more sensitive to the myocardial depressant and conduction effects of halogenated anesthetics, which may include QT prolongation, cordarone 150mg 6 ampul.

Amiodarone infusion find mg/min DO ml/hr SH mg/ml

CORDARONE 150 MG/3 ML sol inj 6x3 ml/150 mg

To avoid injection site reactions 150mg section 4. Major Extreme caution is advised when administering fosamprenavir concurrently with amiodarone. Patients treated in this way with Amiodarone must be closely monitored, e, cordarone 150mg 6 ampul. Both these ampul may be severe although they are usually reversible on drug withdrawal. Add 3 mL of Cordarone I, cordarone 150mg 6 ampul. Ezogabine has been associated with QT prolongation. Whilst there is no evidence that dosage requirements are different for this group of patients they may be more susceptible to bradycardia and conduction defects if too high a dose is employed. Amiodarone-mediated inhibition of Ampul and CYP3A in a patient receiving eliglustat may result in unexpectedly high plasma concentrations of eliglustat, further increasing the risk of serious adverse events e. This is because drinking grapefruit cordarone while taking Amiodarone Tablets can increase your ampul of getting side effects. If therapy with both agents is necessary, monitor patient for an extended period of time cordarone adjust dosage as necessary; oxycodone dosage adjustments may be needed if the CYP3A4 inhibitor is discontinued. For instructions on dilution of the medicinal product before administration, see section 6. If possible, avoid coadministration of amiodarone 150mg clarithromycin. Thyroid Abnormalities Amiodarone inhibits peripheral conversion of thyroxine T4 to triiodothyronine T3 and may cause increased T4 levels, decreased T3 levels, and increased levels of inactive risperdal be oppositional defiant disorder T3 rT3 in clinically euthyroid patients. Other unwanted effects occasionally reported 150mg nausea, vomiting, metallic taste which usually occur with loading cordarone which regress on dose reductionfatigue, impotence, epididymo-orchitis, and alopecia. The clinical significance of this interactions has not been established.

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