Generic Name: Cordarone
What is Cordarone?
The diagnosis is supported by an increase in serum usTSH and an exaggerated TSH response to TRH. T3 and T4 levels may be low. Euthyroidism is usually obtained within 3 months following the discontinuation of treatment. In life-threatening situations, amiodarone therapy can be continued, in combination with L-Thyroxine. The dose of L-Thyroxine is adjusted according to TSH levels. Anaesthesia see sections 4. Fluroquinolones should be avoided in patients receiving Amiodarone.
In cases of hypokalaemia, corrective action should be taken and QT interval monitored. Potentially severe complications have been reported in patients taking amiodarone undergoing general anaesthesia: bradycardia unresponsive to atropine, hypotension, conduction disorder, decreased cardiac output.
Very rare cases of severe respiratory complications adult acute respiratory distress syndromesometimes fatal, have been observed usually in the period immediately following surgery. A possible interaction with a high oxygen concentration may be implicated. Due to the long half life of amiodarone, interactions may be observed for several months after discontinuation of amiodarone.
Quinine has been associated with prolongation of the QT interval and rare cases of TdP. Amiodarone, a Class III antiarrhythmic agent, is also associated with a well-established risk of QT prolongation and TdP.
In addition, concentrations of both drugs may be increased during concomitant use. Amiodarone is a CYP3A4 substrate and P-glycoprotein P-gp inhibitor and quinine is a CYP3A4 inhibitor and P-gp substrate. Ramelteon: Caution is recommended during concomitant use of ramelteon and amiodarone. Because ramelteon is metabolized by CYP3A4 and CYP1A2, use with CYP3A4 and CYP1A2 inhibitors, such as amiodarone, may increase exposure to ramelteon and the potential for adverse effects.
If amiodarone must be administered with ramelteon, monitor the patient closely for toxicity due to increased ramelteon concentrations. Ranolazine: Ranolazine is metabolized mainly by CYP3A and to a lesser extent by CYP2D6.
According to the manufacturer, the ranolazine dosage should be limited to 500 mg PO twice daily for patients receiving drugs known to be moderate CYP3A inhibitors. Although not specifically mentioned by the manufacturer, amiodarone is known to inhibit CYP3A4 and CYP2D6. A reduction in the ranolazine dose may be prudent if these two agents are administered concurrently. In addition, ranolazine is associated with dose- and plasma concentration-related increases in the QTc interval.
The mean increase in QTc is about 6 milliseconds, measured at the tmax of the maximum dosage 1000 mg PO twice daily.
How should I take Cordarone?
Maprotiline: If possible, avoid coadministration of amiodarone and drugs known to prolong the QT interval. Maprotiline has been reported to prolong the QT interval, particularly in overdose or with higher-dose prescription therapy elevated serum concentrations. Cases of long QT syndrome and torsade de pointes TdP tachycardia have been described with maprotiline use, but rarely occur when the drug is used alone in normal prescribed doses and in the absence of other known risk factors for QT prolongation.
Limited data are available regarding the safety of maprotiline in combination with other QT-prolonging drugs. Additionally, amiodarone may also inhibit the CYP2D6 metabolism of maprotiline. Maraviroc: Use caution if coadministration of maraviroc with amiodarone is necessary, due to a possible increase in maraviroc exposure.
What should I avoid while taking Cordarone?
It works by relaxing overactive heart musclesQ. Is amiodarone rich in iodine. Is amiodarone safe or is amiodarone safe to take. Amiodarone is relatively safe if used at prescribed doses for the prescribed duration as advised by your doctorQ. It can be dangerous if taken in inappropriate dosesQ. Can I take amiodarone with Viagra sildenafil or Tylenol acetaminophen or ibuprofen or Benadryl diphenhydramine.
Cordarone side effects
Amiodarone is effective for maintaining sinus rhythm but has greater toxicities than other anti-arrhythmics used in atrial fibrillation.
Amiodarone may be a reasonable first-line agent in patients with concomitant heart failure or substantial left ventricular hypertrophy if rhythm control is preferred over rate control. The federal Omnibus Budget Reconciliation Act OBRA regulates medication use in residents of long-term care facilities LTCFs. According to the OBRA guidelines, antiarrhythmics can have serious adverse effects e. The only approved indication for amiodarone is to treat documented life-threatening recurrent ventricular arrhythmias that do not respond to other antiarrhythmics or when alternative agents are not tolerated.
However, a common off-label use of amiodarone is the treatment of atrial fibrillation. The literature suggests that in many higher risk individuals, alternative approaches are equally effective and less toxic. It is essential to carefully consider risks and benefits, use the lowest possible dose for the shortest possible duration, closely monitor patients receiving long-term treatments, and seek and identify adverse consequences.
Common Cordarone ide effects may include:
Nursing offspring of lactating rats administered Cordarone have been shown to be less viable and have reduced body-weight gains.
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The clinical relevance of this finding is unknown.
Although not specifically mentioned by the manufacturer, amiodarone is known to inhibit CYP3A4 and CYP2D6.
Co administration with P-gp substrates is expected to result in an increase of their exposure: - Digitalis: administration of Cordarone X 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.
Effect of other products on amiodarone CYP3A4 inhibitors and CYP2C8 inhibitors may have a potential to inhibit amiodarone metabolism and to increase its exposure. It is recommended to avoid CYP 3A4 inhibitors during treatment with amiodarone.
Where can I get more information?
Fluoroquinolones, macrolide antibiotics, and azoles are known to cause QTc prolongation.
Monitor patients during anagrelide therapy for cardiovascular effects and evaluate as necessary.