Amiodarone
Brand: Pacerone, Nexterone
Boxed warning · ISMP high-alert drug
Pulmonary toxicity, hepatic injury, and worsened arrhythmia; use only for life-threatening arrhythmias.
- Caution
- Thyroid dysfunction, corneal deposits, and blue-gray skin discoloration with long-term use.
- Pregnancy
- Avoid in pregnancy: fetal thyroid harm and bradycardia.
Common side effects
- Thyroid over- or underactivity
- Blue-gray skin discoloration
- Corneal deposits
- Dry cough and breathlessness
Key interactions
- Raises digoxin levels: the digoxin dose is usually halved
- Raises warfarin's effect; INR must be watched
- Grapefruit juice raises amiodarone levels
- Many QT-prolonging drugs add risk
Counseling points
- Report a new dry cough or shortness of breath promptly
- Use sun protection. Skin can discolor
- Thyroid, liver, and lung function are checked periodically
- Eye exams are recommended
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