📌 Medicine Name:
Amiodarone Tablet 200 mg
(Commonly available as Amiodarone hydrochloride)
📋 Description / Prescription:
Amiodarone is a Class III antiarrhythmic agent used under strict prescription to treat life-threatening atrial and ventricular arrhythmias.
- Form: Oral tablet
- Strength: 200 mg
- Route: Oral
- Available as: Branded and generic tablets
- Prescription Required: ✔️ Yes
🩺 Indications / Uses:
Amiodarone 200 mg is typically prescribed for:
- Life-threatening ventricular arrhythmias (e.g., ventricular tachycardia, ventricular fibrillation)
- Atrial fibrillation (AF)—especially in patients who are unresponsive to or intolerant of other medications
- Paroxysmal supraventricular tachycardia (PSVT)
- Atrial flutter
Also used for maintenance of sinus rhythm after cardioversion.
🔬 Nature / Mechanism of Action:
Amiodarone blocks multiple ion channels and has characteristics of all four Vaughan-Williams classes:
- Class III (main effect): Blocks potassium channels → prolongs repolarization and refractory period
- Also: Blocks sodium (Class I), calcium channels (Class IV), and beta-adrenergic receptors (Class II)
- Slows conduction through SA and AV nodes
- Prolongs action potential duration and QT interval
🕒 Onset: Days to weeks (requires loading dose)
⏳ Half-life: Very long (20–100 days)
🧬 Highly lipophilic, accumulates in tissues
✅ Advantages / Benefits:
- ✅ Effective in both atrial and ventricular arrhythmias
- ✅ Suitable in patients with structural heart disease or heart failure
- ✅ Reduces recurrence of AF/VT
- ✅ Can be used in emergency and chronic therapy
- ✅ Less proarrhythmic than other agents despite QT prolongation
📦 Common Packaging:
- Available in blister packs or bottles
- Common sizes: 10, 30, 100 tablets
- Tablets are usually round, white or off-white
- May be scored for splitting
🌡️ Storage Conditions:
- Store at 15–25°C (59–77°F)
- Protect from light, moisture, and heat
- Keep in original packaging
- Keep out of reach of children
⚠️ Precautions / Contraindications:
Do not use in patients with:
- Sinus node dysfunction
- 2nd or 3rd-degree AV block (without pacemaker)
- Bradycardia with syncope
- Severe liver disease
- Pregnancy (especially in the first trimester)
- Breastfeeding
Use with caution in:
- Thyroid disorders (Amiodarone contains iodine)
- Pulmonary disease (can cause lung toxicity)
- Eye conditions (optic neuropathy/neuritis)
- Elderly patients
- Patients on interacting drugs (e.g., warfarin, digoxin, statins)
🧪 Important Monitoring:
- Thyroid function tests (baseline, then every 6 months)
- Liver function tests (baseline and periodically)
- Chest X-ray or pulmonary function test (baseline, then yearly)
- ECG (monitor QT interval)
- Ophthalmologic exams (if visual symptoms appear)
💊 Typical Dosing Regimen:
Oral Loading dose (initial):
- 800–1600 mg/day (in divided doses) for 1–3 weeks
- Then taper to 400–600 mg/day for 1 month
- Maintenance dose: 200 mg/day or alternate days
Dose varies based on patient condition and response. Always follow physician’s instructions.
👩⚕️ Patient Advice / Counseling Points:
- Take with meals to reduce stomach upset
- Do not stop abruptly—risk of rebound arrhythmia
- Avoid grapefruit juice (increases drug levels)
- Use broad-spectrum sunscreen (photosensitivity risk)
- Report:
- Shortness of breath or persistent cough (lung toxicity)
- Vision changes or blurred vision (eye toxicity)
- Fatigue, weight changes, neck swelling (thyroid problems)
- Dark urine, yellowing of eyes/skin (liver issues)
- Pregnant or breastfeeding women should not take it unless advised