Monograph Details
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Cardiovascular System
> CHF and arrhythmias
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CORDARONE |
| Manufacturer |
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Wyeth Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Class III antiarrhythmic. |
| Generic Name |
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Amiodarone HCl 200mg; scored tabs. |
| Indications |
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Documented, life-threatening recurrent refractory ventricular fibrillation or hemodynamically unstable ventricular tachycardia. |
| Children |
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Not recommended. |
| Adults |
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Give consistently with regard to meals. Initiate in hospital with cardiac monitoring: 800–1600mg/day in divided doses with meals for 1–3 weeks. After control achieved, 600–800mg/day for 1 month then reduce to maintenance dose, usually 400mg/day. |
| Contraindications |
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Severe sinus node dysfunction. 2nd- or 3rd-degree AV block. Bradycardia with syncope unless paced. Cardiogenic shock. |
| Precautions |
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Be experienced with the treatment and monitoring of life-threatening arrhythmias before prescribing this medication. Before use, correct potassium and magnesium deficiencies. Surgery. Monitor thyroid function. Monitor for pulmonary and liver toxicity; reduce dose or discontinue if either occurs. Do regular ophthalmic exams. Withdraw cautiously. Pregnancy (Cat.D). Nursing mothers: not recommended. |
| Interactions |
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Interactions may persist months after discontinuing. Potentiates antiarrhythmics (eg, quinidine, procainamide; reduce their doses by 1/3 to 1/2), cyclosporine, digoxin (reduce digoxin dose by 1/2 or discontinue), oral anticoagulants (reduce anticoagulant dose by 1/3 to 1/2 and monitor PT), phenytoin, lidocaine. Myopathy with statins metabolized by CYP3A4. Potentiated by protease inhibitors, cimetidine. Exacerbation of arrhythmias with antiarrhythmics. Additive bradycardia, AV block with β-blockers, calcium channel blockers, fentanyl. QTc prolongation with quinolones, macrolides, azole antifungals. Antagonized by rifampin, St. John's wort, cholestyramine. May affect thyroid function tests. See literature. |
| Adverse Reactions |
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Alveolitis, pulmonary inflammation or fibrosis, post-op adult respiratory distress syndrome, exacerbation of arrhythmias, heart block or failure, sinus bradycardia, hepatotoxicity, corneal deposits, optic neuropathy/neuritis (reevaluate if occurs), photosensitivity, skin pigmentation, thyroid disorders, malaise, peripheral neuropathy, GI upset, blood dyscrasias, pancreatitis. |
| How Supplied |
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Tabs—60 |
| Additional Resources |
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• Related Prescribing Note |
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