Amiodarone

Sounds like 'ami-o-da-rone'

Easy-to-read medicine information about amiodarone – what it is, how to take amiodarone safely and possible side effects.

Type of medicine  Also called
  • To control irregular heart rate
  • Cordarone X ®
  • Aratac ®
As of 1 July 2019, the brand of amiodarone tablets called Cordarone-X will be replaced by a brand called Aratac. Read more.

What is amiodarone?

Amiodarone is used to control an irregular or fast heart rate, including a condition called atrial fibrillation (AF). It works by slowing the electrical signals sent through the heart. In New Zealand, amiodarone is available as tablets (100 milligram or 200 milligram) and as an injection that is used in hospitals.  

Dose

  • The usual dose of amiodarone is 100 milligrams or 200 milligrams once daily.
  • Most people start with a higher dose and reduce the dose very slowly over a few weeks.
  • Some people may need amiodarone injection in the hospital before starting amiodarone tablets.  
  • Always take your amiodarone exactly as your doctor 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.

How to take amiodarone?

  • Swallow your tablets with a glass of water.
  • You can take amiodarone with or without food.
  • Avoid grapefruit juice while taking amiodarone. These can increase your chance of side effects.
  • Limit or avoid drinking alcohol while you are taking amiodarone.
  • If your tablets look different to your last supply speak with your doctor or pharmacist for advice.
  • If you forget to take your tablet, take it as soon as you remember that day. But, if it is nearly time for your next tablet, just take the next tablet at the right time. Do not take double the amount of tablets.
  • Do not stop taking amiodarone, even if you feel better. Speak to your doctor or nurse before stopping.

Special instructions

Sun protection

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

  • using an SPF30+ sunscreen.
  • 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 are taking it. Most people also need to have a chest x-ray and ECG test once a year while taking amiodarone.

Precautions – before starting amiodarone

  • Do you have any heart problems such as heart failure? 
  • Do you have any breathing or lung problems?
  • Do you have problems with your thyroid?
  • Do you have any eye problems?
  • Are you pregnant or breastfeeding?
  • Are you taking any other medicines, including medicines you can buy without a prescription, such as herbal and complementary medicines?

If any of these apply, it’s important that you tell your doctor or pharmacist before you start amiodarone. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Possible side effects

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 are most at risk if you:

  • are on doses greater than 400 milligrams daily
  • have been taking amiodarone for longer than 2 months
  • are male
  • are aged over 60 years
  • 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, restless, changes in your weight and increased sweating. 

Other side effects

 Side effects  What should I do?
  • Nausea (feeling sick) or vomiting
  • Try taking amiodarone after a meal.
  • Tell your doctor if troublesome.
  • Changes in taste or smell
  • Problems with sleep
  • Headache
  • These usually go away with time.
  • Tell your doctor if troublesome.
  • Feeling faint, dizzy or tired
  • Grey colour of your skin
  • Tell your doctor
  • Signs of problems with your thyroid such as feeling tired, restless, changes in your weight and increased sweating
  • Tell your doctor
  • Signs of problems with your eyes such as a blue halo effect when looking at bright lights at nighttime
  • Tell your doctor  
  • Signs of problems with your liver such as yellowing of the skin or eyes, dark urine, pain in the abdomen.
  • 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.
 
 
  • Tell your doctor immediately or ring HealthLine 0800 611 116
  • Allergic reaction such as skin rashes or itches, swelling of the face, lips, mouth.  
  • Tell your doctor immediately or ring HealthLine 0800 611 116

Interactions

Amiodarone interacts with many medicines including atorvastatin and simvastatin, digoxin and warfarin. It also interacts with some herbal supplements, so check with your doctor or pharmacist before starting amiodarone or before starting any new medicines.

Learn more

Medsafe Consumer Information Sheet Cordarone X    
New Zealand Formulary Patient Information Amiodarone

References

  1. amiodarone hydrochloride New Zealand Formulary
  2. Amiodarone brand-change and a reminder on patient monitoring BPAC, 2016
  3. Amiodarone – safe prescribing – keep an eye on it SAFERx, 2015
  4. Management of atrial fibrillation in general practice October 2011
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 24 Jan 2018