Take amiodarone exactly as directed by your doctor even though you may feel well. Do not take more medicine than ordered and do not miss any doses.

Oral amiodarone should not be taken with grapefruit juice or other grapefruit products because these may increase the concentrations of amiodarone in the body.

Dosing

The dose of amiodarone will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of amiodarone. If your dose is different, do not change it unless your doctor tells you to do so:

• For oral dosage form (tablets):
  • For treatment of ventricular arrhythmias:
    • Adults At first, 800 to 1600 milligrams (mg) per day taken in divided doses. Then, 600 to 800 mg per day for one month. Then, 400 mg per day.
    • Children Dose is based on body weight and must be determined by your doctor. The dose for the first ten days is usually 10 mg per kilogram (4.55 mg per pound) of body weight per day. Then, the dose is decreased to 5 mg per kilogram (2.27 mg per pound) of body weight per day. After several weeks, the dose is then decreased to 2.5 mg per kilogram (1.14 mg per pound) of body weight per day.
• For injection dosage form:
  • For treatment of ventricular arrhythmias
    • Adults At first, the dose is 150 mg injected into a vein for ten minutes, followed by a dose of 360 mg injected into a vein for six hours, followed by a dose of 540 mg injected into a vein for eighteen hours. After the first twenty-four hours of therapy, the dose is 720 mg injected into a vein every twenty-four hours; this dose may be continued for as long as three weeks.
    • Children Use is not recommended.

Missed dose

If you miss a dose of this medicine, do not take the missed dose at all and do not double the next one. Instead, go back to your regular dosing schedule. If you miss two or more doses in a row, check with your doctor.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For amiodarone, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to amiodarone or iodine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy Amiodarone has been shown to cause thyroid problems in babies whose mothers took amiodarone when pregnant. In addition, there is concern that amiodarone could cause slow heartbeat in the newborn. However, this medicine may be needed in serious situations that threaten the mother's life. Be sure you have discussed this with your doctor before taking this medicine.

Breast-feeding Although amiodarone passes into breast milk, it has not been shown to cause problems in nursing babies. However, amiodarone has been shown to cause growth problems in rats. It may be necessary for you to stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of the medicine with your doctor.

Children Amiodarone can cause serious side effects in any patient. Therefore, it is especially important that you discuss with the child's doctor the good that this medicine may do as well as the risks of using it.

Older adults Elderly patients may be more likely to get thyroid problems with this medicine. Also, difficulty in walking and numbness, tingling, trembling, or weakness in hands or feet are more likely to occur in the elderly.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicines, herbal supplements including St. John's Wort, or vitamin supplements. When you are taking amiodarone, it is especially important that your health care professional know if you are taking any of the following:

• Anticoagulants (blood thinners) or
• Other heart medicine or
• Phenytoin (e.g., Dilantin) Effects may be increased

• Azoles (e.g., fluconazole [Diflucan], miconazole injection [Monistat IV], ketoconazole [Nizoral], itraconazole [Sporanox], voriconazole [Vfend]) or
• Fluoroquinolones (ciprofloxacin [e.g., Cipro], enoxacin [e.g., Penetrex], grepafloxacin [e.g., Raxar], levofloxacin [e.g., Levaquin], lomefloxacin [e.g., Maxaquin], norfloxacin [e.g., Noroxin], ofloxacin [e.g., Floxin], sparfloxacin [e.g., Zagam]) or
• Macrolide antibiotics (azithromycin [e.g., Zithromax], clarithromycin [e.g., Biazin], erythromycin [e.g., Ery-Tab]) Heart problems can result when any of these medicines are given together with amiodarone.

• Fentanyl (e.g., Duragesic) Using this medicine together with amiodarone may cause low blood pressure, slowed heart rate, and other heart problems.

• Simvastatin (e.g., Zocor) May cause adverse effects with the nervous system and muscles

• Heartbeat problems Amiodarone may make these problems worse.

• Hepatitis, acute Risk of adverse effects is increased.
• Liver disease Effects of amiodarone may be increased because of slower removal from the body

• Thyroid problems Risk of overactive or underactive thyroid is increased