The benefit of amiodarone in the treatment of atrial fibrillation in the critical care population has yet to be determined but it may prove to be the agent of choice where the patient is hemodynamically unstable and unsuitable for DC cardioversion. Amiodarone is a benzofuran derivative: Methanone, (2-butyl-3-benzofuranyl)[4-[2-(diethylamino)ethoxy]-3,5-diiodophenyl]-, hydrochloride.Amiodarone HCl is a white or almost white fine crystalline powder. See “What are the possible side effects of Amiodarone hydrochloride tablets, USP?” If you get serious side effects during treatment you may need to stop Amiodarone hydrochloride tablets, USP, have your dose changed, or get medical treatment. Amiodarone hydrochloride tablets, USP are indicated for the treatment of documented, life-threatening recurrent ventricular fibrillation and life-threatening recurrent hemodynamically unstable tachycardia in adults who have not responded to adequate doses of other available antiarrhythmics or when alternative agents cannot be tolerated.Dosage must be individualized based on severity of arrhythmia and response. The development of maximal ventricular class III effects after oral Amiodarone hydrochloride administration in humans correlates more closely with DEA accumulation over time than with Amiodarone accumulation.Following single dose administration in 12 healthy subjects, Amiodarone hydrochloride exhibited multi-compartmental pharmacokinetics with a mean apparent plasma terminal elimination half-life of 58 days (range 15 to 142 days) for Amiodarone and 36 days (range 14 to 75 days) for the active metabolite (DEA). Some reversal of discoloration may occur upon drug discontinuation.Patients on Amiodarone hydrochloride therapy may be more sensitive to the myocardial depressant and conduction effects of halogenated inhalational anesthetics.The following serious adverse reactions are described in more detail in other sections of the prescribing information:Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.At the usual maintenance dose (400 mg/day) and above, Amiodarone hydrochloride causes adverse reactions in about three-fourths of all patients, resulting in discontinuation in 7 to 18%.In surveys of almost 5,000 patients treated in open U.S. studies and in published reports of treatment with Amiodarone hydrochloride, the adverse reactions most frequently requiring discontinuation of Amiodarone hydrochloride included pulmonary infiltrates or fibrosis, paroxysmal ventricular tachycardia, congestive heart failure, and elevation of liver enzymes.

(These doses in the rat are approximately 0.8, 1.6 and 3.2 times the maximum recommended human maintenance dose*) Adverse effects on fetal growth and survival also were noted in one of two strains of mice at a dose of 5 mg/kg/day (approximately 0.04 times the maximum recommended human maintenance dose*). Select one or more newsletters to continue. Evidence in cardiac arrest, however, is poor. In these cases, amiodarone can be used regardless of the individual's underlying heart function and the type of ventricular tachycardia; it can be used in individuals with So-called 'acute onset atrial fibrillation', defined by the North American Society of Pacing and Electrophysiology (NASPE) in 2003, responds well to short duration treatment with amiodarone. It is used both in supraventricular arrhythmias and ventricular arrhythmias. Amiodarone hydrochloride increases the cardiac refractory period without influencing resting membrane potential, except in automatic cells where the slope of the prepotential is reduced, generally reducing automaticity. Neither Amiodarone nor DEA is dialyzable.Although no dosage adjustment for patients with renal, hepatic, or cardiac abnormalities has been defined during chronic treatment with oral Amiodarone, close clinical monitoring is prudent for elderly patients and those with severe left ventricular dysfunction.Amiodarone HCl was associated with a statistically significant, dose-related increase in the incidence of thyroid tumors (follicular adenoma and/or carcinoma) in rats.

It can be given by mouth, intravenously, or intraosseously.

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