Amiodarone Tablets

Amiodarone is an antiarrhythmic drug. It is prescribed for patients with ischemic heart disease with restless and tension angina syndromes.

Antiarrhythmic action is characterized by an effect on the electrophysiological process in the myocardium. The drug is able to extend the action potential of cardiomyocytes, to increase the effective refractory period of the ventricles and atria. The antianginal effect is explained by the coronavigation effect, the decrease in the need of the heart muscle in oxygen.

On this page you will find all information about Amiodarone: the full instructions for use on this medication, average prices in pharmacies, complete and incomplete analogs of the drug, as well as reviews of people who have already used Amiodarone. Want to leave your opinion? Please write in the comments.

Clinical and pharmacological group

Antiarrhythmic remedy class 3, has an antianginal effect.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much does Amiodarone cost? The average price in pharmacies is at the level of80 rubles.

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Form of issue and composition

Produced in the form of white tablets of round, flat-cylindrical form, having a one-sided chamfer and risk.

Amiodarone hydrochloride - in 1 table. 200 mg.
Contains the following excipients: povidone, corn starch, Mg stearate, silicon dioxide, colloidal, Na starch glycolate, microcrystalline cellulose.

Tablets are packaged in blisters (10 pcs.), Cardboard packing.

Pharmacological effect

Amiodarone is an antiarrhythmic drug of the III class. It also has alpha and beta adrenoblocking, antianginal, antihypertensive and coronarodilating action.

The drug blocks unactivated potassium channels in the cell membranes of cardiomyocytes. To a lesser extent, it acts on the sodium and calcium channels. By blocking inactivated "fast" sodium channels, it produces effects that are characteristic of class I antiarrhythmic drugs. Amiodarone causes bradycardia, inhibiting the slow depolarization of the membrane of the cells of the sinus node, and also inhibits atrioventricular conduction (the effect of antiarrhythmic drugs of Class IV).

Antiarrhythmic effect of the drug is due to its ability to increase the duration of the action potential of cardiomyocytes and the refractory (effective) period of the ventricles and the atria of the heart, the bundle of the Hyis, the AV node and the Purkinje fibers, resulting in a decrease in the automatism of the sinus node, the excitability of the cardiomyocytes, and slowing AV conduction.

The antianginal effect of the drug is due to a decrease in the resistance of the coronary arteries and a decrease in the need for the myocardium in oxygen because of a decrease in the heart rate, which ultimately leads to an increase in coronary blood flow. The drug does not significantly affect systemic blood pressure.

Indications for use

According to the instructions, Amiodarone is indicated for the prevention of paroxysmal rhythm disturbances, namely:

Atrial fibrillation (atrial fibrillation), atrial flutter;
Ventricular arrhythmias that threaten the patient's life (ventricular fibrillation, ventricular tachycardia);
Supraventricular arrhythmias (including with organic heart diseases or when alternative antiarrhythmic therapy is not possible);
Attacks of recurrent persistent supraventricular paroxysmal tachycardia in patients with Wolff-Parkinson-White syndrome.

Contraindications

This drug is contraindicated in the blockade of SA and AV 2-3 degrees, sinus bradycardia, collapse, hypersensitivity, cardiogenic shock, hypokalemia, pulmonary interstitial diseases, hypothyroidism, thyrotoxicosis, during pregnancy, lactation and administration of MAO inhibitors.

In addition, Amiodarone is prescribed with caution to people suffering from kidney failure, chronic heart failure and bronchial asthma. Also, this drug should be gently taken to children under 18 years old and elderly patients.

Instructions for use Amiodarone

The instructions for use indicate that Amiodarone tablets should be taken orally, before meals, with the necessary amount of water to swallow. Instructions for use Amiodarone suggests an individual dosing regimen, which should be installed and adjusted by the attending physician.

Standard dosing schedule:

Load (in a different way saturating) the initial dose for inpatient treatment, which is divided into several receptions, is 600-800 mg per day, and the maximum allowable daily dose is up to 1200 mg. It should be taken into account that the total dose should be 10 g, usually it is achieved in 5-8 days.
For outpatient treatment, an initial dose of 600-800 mg per day is prescribed, which is divided into several doses, and also reaches a total dose of not more than 10 g, but for 10-14 days.
To continue the course of treatment with Amiodarone, it is enough to take 100-400 mg per day. Attention! The minimum effective maintenance dose is used.
To avoid cumulation of the drug, you must take the pill every other day, or with a break in 2 days 1 time a week.
The average single dose, which has a therapeutic effect, is 200 mg.
The average daily dose is 400 mg.
The maximum allowable dose is not more than 400 mg per time, not more than 1200 mg per 1 knock.
For children, the dose is usually in the range of 2.5-10 mg per day.

Side effects

The use of Amiodarone can cause the following side reactions:

Nervous system: extrapyramidal disorders, tremor, nightmares, sleep disorders, peripheral neuropathy, myopathy, cerebellar ataxia, headache, pseudotumor brain;
Skin reactions: photosensitization, with prolonged use of the drug - lead blue or blue skin pigmentation, erythema, exfoliative dermatitis, skin rash, alopecia, vasculitis;
Respiratory system: interstitial or alveolar pneumonitis, pulmonary fibrosis, pleurisy, bronchitis obliterans with pneumonia, including with fatal outcome, acute respiratory syndrome, pulmonary hemorrhage, bronchospasm (especially in patients with bronchial asthma);
Organs of senses: optic neuritis, deposition of lipofuscin in the epithelium of the cornea;
Endocrine system: increase in the level of the hormone T4, accompanied by a slight decrease in T3 (does not require discontinuation of Amiodarone treatment in case the thyroid function is not violated). With prolonged use, hypothyroidism may develop, and hyperthyroidism may be less likely to require the drug to be withdrawn. Very seldom there can be a syndrome of disturbance of the secretion of ADH;
Cardiovascular system: moderate bradycardia, sinoatrial block, pro-arrhythmic action, AV blockade of various degrees, stop of sinus node. With prolonged use of the drug, the progression of symptoms of chronic heart failure is possible;
Digestive system: nausea, vomiting, taste disorder, decreased appetite, increased hepatic activity enzymes, heaviness in epigastrium, acute toxic hepatitis, jaundice, liver failure;
Laboratory indicators: aplastic or hemolytic anemia, thrombocytopenia;
Other adverse reactions: decreased potency, epididymitis.

Overdose

Taking large doses of amiodarone can lead to the following conditions:

Hypotension;
Bradycardia;
AV blockade;
Asystole;
Cardiogenic shock;
Liver dysfunction;
Heart failure.

The patient should be immediately taken to a medical facility. Treatment of an overdose with amiodarone is aimed at detoxifying the body (gastric lavage, taking enterosorbents) and eliminating symptoms.

special instructions

Reception of the drug is possible only after the appointment of a doctor who determines the treatment regimen and dosage based on the data of the clinical study and ECG. It is also necessary to take into account such specific instructions:

Before starting the use of the drug, it is recommended to conduct a study of the functional activity of the thyroid gland and the level of its hormones in the blood.
With prolonged use, ECG cardiac monitoring, determination of the level of thyroid hormones and hepatic enzymes in the blood are mandatory.
With increased caution and with the constant ECG control of the heart, Amiodarone tablets are prescribed when combined with beta-blockers, laxatives and diuretics, which remove potassium ions from the body (potassium is not saving diuretics - furosemide), anticoagulants (warfarin), some antibiotics (rifampicin) and antiviral agents (especially drugs that inhibit reverse transcriptase of viruses).
It is impossible to combine the use of Amiodarone tablets with other antiarrhythmic drugs, as this will lead to an increase in its effects and the development of disturbances in the functional activity of the heart. Also a combination with antimalarials, antibiotics of the macrolide group, fluoroquinolones is excluded.
In the case of coughing and shortness of breath, an x-ray examination of the thoracic organs is performed to differentiate the inflammatory pathology of the respiratory organs.
During the reception of Amiodarone tablets, it is necessary to abandon the activity associated with increased concentration of attention and requiring a high rate of psychomotor reactions.

In pharmacies, the drug is only released on prescription.

Drug Interactions

Categorically contraindicated combination of amiodarone with drugs belonging to the groups:

Fluoroquinolones;
Beta-blockers;
Laxatives;
Antiarrhythmic drugs of class 1;
Neuroleptics;
Tricyclic antidepressants;
Macrolides;
Anti-malarial.

Co-administration of these agents with amiodarone can lead to the appearance of pronounced side effects, often life-threatening.

The pharmacokinetics of the drug are affected by:

Cholinesterase inhibitors;
Orlistat;
Kolestyramine;
Anticoagulants;
Cardiac glycosides;
Antiviral drugs;
Cimetidine.

Amiodarone itself is able to influence the concentrations of cyclosporine, lidocaine, statins, sodium iodide.

Reviews

Most patients note the stabilization of their condition after taking Amiodarone. Instructions for use - analogues to the drug are often selected based on the individual characteristics of the body - it promises normalization of the heart rhythm, pressure.

With short-term admission and in small doses, as a rule, problems do not arise, and the drug has an effective effect. After a long medication, some patients developed shortness of breath, palpitations, nervousness and depression, sharp mood swings and an increase in thyroid hormones, an upset of the gastrointestinal tract, and in some cases nausea and vomiting.

Many people use this drug in the treatment of angina, and note that it is no worse than imported analogues. Some men are afraid to take the drug, because it is they who can cause a number of oncological diseases. There is an opinion that the drug should be taken only in a condition that threatens human life, in all other situations it should look for an alternative. In addition, tablets can adversely affect the reproductive function of a man, which must also be taken into account when receiving them.

Nevertheless, for many people, Amiodarone was a panacea, due to which the disease receded, and the person remained alive. It's not a fact that analogs would be just as effective. Therefore, in the treatment of heart disease, you should not discard this medicine, especially if the doctor recommends it.