Amiodarone

Amiodarone
Clinical data
Pronunciation/ˌæmiˈoʊdəroʊn/ or /əˈmiːoʊdəˌroʊn/
Trade namesCordarone, Nexterone, Pacerone, others
AHFS/Drugs.comMonograph
MedlinePlusa687009
License data
Pregnancy
category
  • AU: C
Routes of
administration		By mouth, intravenous, intraosseous
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability20–55%
Protein binding96%
MetabolismLiver
Elimination half-life58 d (range 15–142 d)
ExcretionPrimarily liver and bile
Identifiers
IUPAC name
  • (2-{4-[(2-butyl-1-benzofuran-3-yl)carbonyl]-2,6-diiodophenoxy}ethyl)diethylamine
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.016.157
Chemical and physical data
FormulaC25H29I2NO3
Molar mass645.320 g·mol−1
3D model (JSmol)
SMILES
  • CCN(CC)CCOc1c(I)cc(cc1I)C(=O)c2c3ccccc3oc2CCCC
InChI
  • InChI=1S/C25H29I2NO3/c1-4-7-11-22-23(18-10-8-9-12-21(18)31-22)24(29)17-15-19(26)25(20(27)16-17)30-14-13-28(5-2)6-3/h8-10,12,15-16H,4-7,11,13-14H2,1-3H3 Y
  • Key:IYIKLHRQXLHMJQ-UHFFFAOYSA-N Y
  (verify)

Amiodarone is an antiarrhythmic medication used to treat and prevent a number of types of cardiac dysrhythmias.[4] This includes ventricular tachycardia, ventricular fibrillation, and wide complex tachycardia, atrial fibrillation, and paroxysmal supraventricular tachycardia.[4] Evidence in cardiac arrest, however, is poor.[5] It can be given by mouth, intravenously, or intraosseously.[4] When used by mouth, it can take a few weeks for effects to begin.[4][6]

Common side effects include feeling tired, tremor, nausea, and constipation.[4] As amiodarone can have serious side effects, it is mainly recommended only for significant ventricular arrhythmias.[4] Serious side effects include lung toxicity[7] such as interstitial pneumonitis, liver problems, heart arrhythmias, vision problems, thyroid problems, and death.[4] If taken during pregnancy or breastfeeding it can cause problems in the fetus or the infant.[4] It is a class III antiarrhythmic medication.[4] It works partly by increasing the time before a heart cell can contract again.[4][6]

Amiodarone was first made in 1961 and came into medical use in 1962 for chest pain believed to be related to the heart.[8] It was pulled from the market in 1967 due to side effects.[9] In 1974 it was found to be useful for arrhythmias and reintroduced.[9] It is on the World Health Organization's List of Essential Medicines.[10] It is available as a generic medication.[4] In 2022, it was the 237th most commonly prescribed medication in the United States, with more than 1 million prescriptions.[11][12]

  1. ^ "Pacerone- amiodarone hydrochloride tablet". DailyMed. Archived from the original on 29 December 2022. Retrieved 8 September 2021.
  2. ^ "Cordarone (amiodarone) tablets, for oral use Initial U.S. Approval: 1985". DailyMed. 30 October 2018. Archived from the original on 29 December 2022. Retrieved 8 September 2021.
  3. ^ "Nexterone- Amiodarone HCl injection, solution". DailyMed. Archived from the original on 29 December 2022. Retrieved 8 September 2021.
  4. ^ a b c d e f g h i j k "Amiodarone Hydrochloride". The American Society of Health-System Pharmacists. Archived from the original on 19 September 2016. Retrieved 22 August 2016.
  5. ^ Ali MU, Fitzpatrick-Lewis D, Kenny M, Raina P, Atkins DL, Soar J, et al. (November 2018). "Effectiveness of antiarrhythmic drugs for shockable cardiac arrest: A systematic review" (PDF). Resuscitation. 132: 63–72. doi:10.1016/j.resuscitation.2018.08.025. PMID 30179691. S2CID 52154562. Archived (PDF) from the original on 5 March 2020. Retrieved 17 December 2019.
  6. ^ a b Review of the Medical Use of Amiodarone (Nexterone, Pacerone). Xavier Research Press. 24 July 2018. ISBN 978-1-7242-7798-5.
  7. ^ Feduska ET, Thoma BN, Torjman MC, Goldhammer JE (May 2021). "Acute Amiodarone Pulmonary Toxicity". J Cardiothorac Vasc Anesth. 35 (5): 1485–1494. doi:10.1053/j.jvca.2020.10.060. PMID 33262034. S2CID 227253264.
  8. ^ Analytical Profiles of Drug Substances and Excipients. Academic Press. 1992. p. 4. ISBN 978-0-08-086115-9. Archived from the original on 8 September 2017.
  9. ^ a b Fischer J, Ganellin CR (2005). Analogue-based Drug Discovery. John Wiley & Sons. p. 12. ISBN 978-3-527-60749-5. Archived from the original on 8 September 2017.
  10. ^ World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
  11. ^ "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
  12. ^ "Amiodarone Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Retrieved 30 August 2024.
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