Amiodarone

General Toxicity Notes
Blood levels most often the best guide to therapy. Half-life may be prolonged in heart failure or with reduced hepatic blood flow.
Excreted Unchanged %
<5
Half-Life (Normalesrd) Hours
14-120 d/Unchanged
Plasma Protein Binding %
96
Volume Of Distribution L/Kg
70-140
Dose For Normal Renal Function
800-2000 mg load, then 200-600 mg q24h
Adjustment For Renal Failure Method
D
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
100% [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: None
Supplement For Dialysis [Recommendation Level]: Pd
PD: None
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, titrate, [D]
References
Gill J, Heel RC, Fitton A. Amiodarone. An overview of its pharmacological properties, and review of its therapeutic use in cardiac arrhythmias. Drugs. 1992; 43: 69-110. [PMID: 1372862] / Mamprin F, Mullins P, Graham T, Kendall S, Biocine B, Large S, et al. Amiodarone-cyclosporine interaction in cardiac transplantation [Letter]. Am Heart J. 1992; 123: 1725-6. [PMID: 1595566] / Roden DM. Pharmacokinetics of amiodarone: implications for drug therapy. Am J Cardiol. 1993; 72: 45F-50F. [PMID: 8237829] / Ujhelyi MR, Klamerus KJ, Vadiei K, O&#146; Rangers E, Izard M, Neefe DL, et al. Disposition of intravenous amiodarone in subjects with normal and impaired renal function. J Clin Pharmacol. 1996; 36: 122-30. [PMID: 8852388]
Toxicity Notes
Hepatotoxicity, thyroid dysfunction, peripheral neuropathy, pulmonary fibrosis. Increased plasma digoxin. Increases cyclosporine levels.