Amiodarone

Sounds like 'a-mee-oh-da-rone'

Key points about amiodarone

Amiodarone is used to manage or prevent an irregular or fast heart rate, including treatment of a condition called atrial fibrillation (AF).
Amiodarone is also called Cordarone X® or Aratac®.
Find out how to take it safely and possible side effects.

Amiodarone is used to manage or prevent an irregular or fast heart rate, including treatment of a condition called atrial fibrillation (AF).

It works by slowing the electrical signals sent through your heart.

In Aotearoa New Zealand, amiodarone is available as Aratac tablets (100 mg or 200 mg) and as Cordarone–X injection that's used in hospitals.

The usual dose of amiodarone is 200 mg once daily.
Most people start with a higher dose and reduce the dose slowly over a few weeks.
Some people may need an amiodarone injection in hospital before starting amiodarone tablets.
Always take your amiodarone exactly as your healthcare provider has told you. The pharmacy label on your medicine will tell you how much amiodarone to take, how often to take it, and any special instructions.

Timing: Swallow your tablets with a glass of water. Take your dose at the same time each day, to help you remember to take it. You can take amiodarone with or without food.
Missed dose: If you forget to take your tablet, take it as soon as you remember. If it's nearly time for your next dose, just take the next dose at the usual time. Don't take double the dose. If you're not sure what to do, ask your healthcare provider.
Keep taking amiodarone regularly. Treatment with amiodarone is usually long term because it prevents, but doesn't cure, your irregular heart beat. You should continue to take it unless you're advised by your healthcare provider to stop. Speak to your healthcare provider before stopping.

Here are some things to know when you're taking amiodarone. Other things may be important as well, so ask your healthcare provider what you should know about.

Sun protection

Amiodarone may make your skin more sensitive to the sun. You may get a burning, tingling feeling on your skin when you're in the sun, or you may notice a darker tan or redness. This can continue for months after stopping amiodarone. It's important not to use sunbeds while taking amiodarone and for several months after you have stopped taking them. When you're outside, protect your skin and eyes by:

using an SPF30+ sunscreen.
wearing a sunhat and clothing that protects you from the sun.
wearing sunglasses.

Blood tests and other monitoring

Amiodarone has some side effects that need monitoring. You will need to have blood tests to check your thyroid and liver before you start taking amiodarone and every 6 months while you're taking it. Most people also need to have a chest X-ray and ECG test once a year while taking amiodarone.

Other things to know

Driving: Amiodarone can make you dizzy. Be careful when driving or using tools until you know how this medicine affects you.
Other medicines: Amiodarone interacts with many medicines including atorvastatin and simvastatin, citalopram, erythromycin, digoxin and warfarin. It may also interact with some herbal supplements and rongoā Māori, so check with your doctor or pharmacist before starting amiodarone and before starting any new products.
Grapefruit, grapefruit juice or sour/Seville oranges: Avoid these, as they can increase your chance of side effects. Read more about grapefruit and medicines.
Pregnancy: If you are planning a pregnancy it’ important to talk to your healthcare provider at least 3 months before you want to become pregnant. Amiodarone stays in your body for a few months after you stop taking it.
If you become pregnant: Tell your doctor immediately.

Like all medicines, amiodarone can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Problems with your lungs

Amiodarone can cause serious lung problems. Although these problems can happen to anyone taking amiodarone, you're most at risk if you:

are on doses greater than 400 mg daily
have been taking amiodarone for longer than 2 months
are male
are over 60 years of age
already had lung problems before starting amiodarone.

Your doctor will check for any changes in your lungs by arranging a chest X-ray once a year (annually).

Tell your doctor immediately if you have any signs of problems with your lungs such as dry cough, shortness of breath or difficulty breathing, fever, chest pain, tiredness or fainting.

Changes in thyroid function

The thyroid is a small, butterfly-shaped gland in your neck. It produces thyroid hormones. Amiodarone can affect your thyroid. Your doctor will look for changes in your thyroid with a blood test before you start taking amiodarone and every 6 months while you are taking it.

Tell your doctor if you have any signs of problems with your thyroid such as feeling tired or restless, or experiencing changes in your weight and increased sweating.

Other side effects

Side effects	What should I do?
Nausea (feeling sick) or vomiting (being sick)	This is very common. Try taking amiodarone after a meal. Tell your doctor if these bother you.
Sensitivity to the sun	This is common. Read more about this in the section above.
Changes in taste or smell Problems with sleep Headache	These are common but usually go away with time. Tell your doctor if these bother you.
Signs of problems with your eyes such as a blue halo effect when looking at bright lights at night time Blurry vision	This is very common. Tell your doctor.
Feeling faint, dizzy or tired	Tell your doctor.
Grey colour of your skin	This is not common. Tell your doctor.
Signs of problems with your thyroid such as feeling tired, restless, changes in your weight and increased sweating	You will have regular blood tests to check for this. Tell your doctor
Signs of problems with your liver such as yellowing of the skin or eyes, dark urine, pain in the abdomen.	This is not common. Tell your doctor immediately or ring Healthline 0800 611 116.
Signs of problems with your lungs such as dry cough, shortness of breath or difficulty breathing, fever, chest pain, tiredness or fainting.	This is not common. Tell your doctor immediately or ring Healthline 0800 611 116.
Allergic reaction such as skin rashes or itches, swelling of the face, lips, mouth.	This is not common. Tell your doctor immediately or ring Healthline 0800 611 116.