amiodarone hydrochloride at a glance
Medicine class
Class III anti-arrhythmic with additional sodium-channel, calcium-channel and anti-adrenergic effects.
Important practical point
Avoid grapefruit juice and protect exposed skin from strong sunlight during treatment and for several months afterwards.
Monitoring
Heart rhythm, thyroid, liver and electrolytes need ongoing review; lung or eye symptoms need prompt investigation.
What is amiodarone hydrochloride used for?
The selected products license amiodarone for severe rhythm disorders when other treatments are ineffective, contraindicated or cannot be used.
Tachyarrhythmias associated with Wolff–Parkinson–White syndrome.
Atrial flutter and atrial fibrillation when other medicines cannot be used.
Paroxysmal supraventricular, nodal and ventricular tachycardias, including serious ventricular arrhythmias.
Ventricular fibrillation, including shock-resistant ventricular fibrillation during cardiopulmonary resuscitation.
Intravenous use when a rapid response is required, oral administration is impossible, or before electrical cardioversion.
How does amiodarone hydrochloride work?
Amiodarone mainly blocks cardiac potassium channels, prolonging repolarisation and the refractory period so abnormal electrical circuits are less able to continue. It also affects sodium and calcium channels and adrenergic signalling, which can slow heart rate and conduction.
amiodarone hydrochloride preparations and strengths
Injection
Route: Parenteral
Strengths: 30 mg/mL, 50 mg/mL, 150 mg/3 mL
How to take amiodarone hydrochloride
Take tablets exactly as prescribed, swallowing them whole. Do not crush, chew or stop them without speaking to the prescriber. Avoid grapefruit juice. Injectable concentrate is prepared and given by healthcare professionals in a monitored hospital or specialist setting.
Protect exposed skin with clothing and high-factor sunscreen; avoid sunbeds.
Tell pharmacists, dentists and clinicians before starting other medicines or having surgery.
Read the leaflet for your product because excipients and preparation instructions differ.
amiodarone hydrochloride side effects
Common or expected effects
- Nausea, vomiting or altered taste.
- Increased sensitivity to sunlight and easier sunburn.
- Corneal deposits, sometimes causing blurred vision or coloured haloes around lights.
- A slower heartbeat.
- Underactive or overactive thyroid function.
- Tremor, nightmares or sleep disturbance.
- Constipation.
Get urgent medical advice
- New breathlessness, persistent dry cough, fever or deteriorating general health, which may indicate lung inflammation or fibrosis.
- Jaundice, abdominal pain, loss of appetite or marked fatigue, which may indicate liver injury.
- A very slow, faint or increasingly irregular heartbeat.
- Marked visual loss, which may indicate optic nerve damage.
- Severe blistering, peeling or mucosal rash, or signs of a serious allergic reaction.
- Symptoms of major thyroid disturbance, including unexplained weight change, heat or cold intolerance, agitation, weakness or neck swelling.
amiodarone hydrochloride in pregnancy
Amiodarone is generally contraindicated during pregnancy because it can affect the fetal thyroid. Use is reserved for exceptional, serious circumstances under specialist care. Discuss planned conception with the specialist before treatment is changed or stopped because the medicine persists in the body.
amiodarone hydrochloride while breastfeeding
Breastfeeding is contraindicated because amiodarone and its iodine-containing metabolites enter breast milk in clinically important amounts. Specialist advice is needed if treatment is essential after childbirth.
amiodarone hydrochloride interactions
Amiodarone has numerous clinically important interactions, some of which can continue for months after it is stopped. A pharmacist or prescriber should check all prescribed, over-the-counter and herbal products.
Warfarin
Can increase anticoagulation and bleeding risk, requiring closer INR monitoring during and after combined use.
Digoxin
Digoxin exposure can increase and both medicines can slow the heart, requiring clinical, ECG and concentration review.
QT-prolonging medicines
Some anti-arrhythmics, antibiotics, antipsychotics, antidepressants, antihistamines and antimalarials can increase the risk of torsades de pointes; several combinations are contraindicated.
Common questions about amiodarone hydrochloride
Answers are fully visible for fast scanning and source review.
Is amiodarone hydrochloride the same as amiodarone?
Yes. Amiodarone hydrochloride is the salt form used as the active ingredient and is commonly shortened to amiodarone.
How long does amiodarone hydrochloride stay in the body?
It has a long and variable elimination half-life. Effects and interactions can continue for months after it is stopped.
Can I go in the sun while taking amiodarone hydrochloride?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.