CORDARONE 200mg Price

Overview

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This medicine contains an important and useful components, as it consists of
Amiodarone HClis available in the market in concentration

Name

Amiodarone Hydrochloride

Precaution

- **Caution in Patients with Heart Issues**: Amiodarone should be used with caution in patients with preexisting heart conditions, especially those with bradycardia, heart block, or sick sinus syndrome, as it can lead to severe cardiac effects, including heart block or arrhythmias. - **Liver Dysfunction**: Amiodarone is metabolized by the liver, and patients with liver dysfunction may require dose adjustments. Regular monitoring of liver enzymes is essential during treatment. - **Thyroid Disorders**: Amiodarone can affect thyroid function, either causing hypothyroidism or hyperthyroidism. It is important to monitor thyroid function regularly, especially in patients with existing thyroid disorders. - **Pulmonary Toxicity**: Long-term use of amiodarone may lead to pulmonary toxicity, including pneumonitis and pulmonary fibrosis. Patients should be monitored for symptoms such as persistent cough, shortness of breath, or chest discomfort. - **Pregnancy**: Amiodarone is contraindicated in pregnancy due to its potential teratogenic effects. It should only be used in pregnancy when absolutely necessary and under careful medical supervision. - **Breastfeeding**: Amiodarone passes into breast milk, and although adverse effects on the infant are rare, its use should be avoided during breastfeeding unless absolutely required. - **Elderly Patients**: Elderly patients may be more sensitive to the drug's effects, particularly regarding liver function, cardiac function, and pulmonary complications. Close monitoring and dose adjustments may be required. - **Photosensitivity**: Amiodarone can cause skin photosensitivity, leading to severe sunburn reactions. Patients should be advised to avoid excessive sun exposure and wear protective clothing and sunscreen.

Indication

- **Arrhythmias**: Amiodarone is primarily indicated for the treatment of various types of arrhythmias, particularly atrial fibrillation, atrial flutter, and ventricular arrhythmias, such as ventricular tachycardia and fibrillation. - **Acute Ventricular Arrhythmias**: It is used for the acute management of life-threatening ventricular arrhythmias, particularly in emergency settings, such as during cardiac arrest. - **Prevention of Recurrence of Arrhythmias**: Amiodarone is also used for the long-term management and prevention of recurrent atrial fibrillation and ventricular arrhythmias, particularly in patients who do not respond to other antiarrhythmic agents. - **Post-Operative Arrhythmias**: Amiodarone is sometimes used in post-operative settings to prevent or treat arrhythmias following heart surgery or other major surgeries, especially in patients at risk for arrhythmia development.

Contra indication

- **Hypersensitivity**: Amiodarone is contraindicated in patients who have a known hypersensitivity to the drug or any of its components. - **Severe Bradycardia**: Due to its negative chronotropic effect, amiodarone is contraindicated in patients with severe bradycardia or sick sinus syndrome, unless a permanent pacemaker is in place. - **Heart Block**: Amiodarone should not be used in patients with second- or third-degree heart block without a functioning pacemaker. - **Severe Liver Disease**: Amiodarone is contraindicated in patients with severe hepatic impairment or active liver disease due to the risk of further liver injury. - **Pregnancy**: Amiodarone is contraindicated during pregnancy due to its potential teratogenic effects and risk of fetal harm. - **Breastfeeding**: It is contraindicated in breastfeeding mothers due to the potential risks to the infant.

Side Effect

- **Common Side Effects**: - Fatigue - Nausea and vomiting - Tremors - Ataxia - Visual disturbances (e.g., blurred vision, corneal deposits) - Photosensitivity and skin discoloration - **Serious Side Effects**: - Pulmonary toxicity (e.g., interstitial pneumonitis, pulmonary fibrosis) - Liver toxicity (hepatitis, cirrhosis) - Thyroid dysfunction (hypothyroidism or hyperthyroidism) - Bradycardia and heart block - Cardiac arrest (especially with overdose) - Peripheral neuropathy - Optic neuropathy (in rare cases, can cause permanent blindness) - **Allergic Reactions**: - Rash - Itching - Fever - Anaphylaxis (rare) - **Drug Toxicity**: - Symptoms of toxicity include severe fatigue, weakness, shortness of breath, abnormal liver function tests, and new or worsening arrhythmias. - Long-term use can result in permanent organ damage, particularly to the lungs, liver, and thyroid.

Pregnancy Category ID

4

Mode of Action

- **Antiarrhythmic Effects**: Amiodarone works by inhibiting multiple ion channels in cardiac cells, including sodium, potassium, and calcium channels. This action helps to stabilize the cell membrane, prolong the action potential duration, and suppress abnormal electrical activity, which reduces arrhythmias. - **Beta-blocker-like Effects**: Amiodarone also has properties similar to beta-blockers, slowing down the heart rate and reducing myocardial oxygen demand. - **Calcium Channel Blockade**: The drug blocks calcium channels, contributing to its ability to reduce the contractility of the heart and slow the conduction of electrical impulses in the atrioventricular (AV) node. - **Thyroid Hormone Modulation**: Amiodarone can inhibit peripheral conversion of thyroxine (T4) to triiodothyronine (T3), which may contribute to thyroid dysfunction, either leading to hypothyroidism or hyperthyroidism. - **Pulmonary Toxicity Mechanism**: Chronic use of amiodarone can lead to pulmonary toxicity by accumulating in the lungs, leading to inflammation and fibrosis.

Interaction

- **Drug Interactions**: - **Warfarin**: Amiodarone can increase the effects of warfarin, leading to an increased risk of bleeding. Monitoring of INR levels is recommended when both drugs are used together. - **Digoxin**: Amiodarone increases the plasma concentration of digoxin, raising the risk of digoxin toxicity. Digoxin dose reduction may be necessary. - **Beta-blockers and Calcium Channel Blockers**: Concurrent use with beta-blockers or calcium channel blockers can lead to excessive bradycardia and hypotension. Monitoring and dose adjustments may be necessary. - **CYP3A4 Inhibitors/Inducers**: Amiodarone is metabolized by the cytochrome P450 3A4 system. Drugs that inhibit this enzyme (e.g., grapefruit juice, certain antifungals) can increase amiodarone levels, while inducers (e.g., rifampin) can decrease its efficacy. - **Other Antiarrhythmic Drugs**: Combining amiodarone with other antiarrhythmic drugs can increase the risk of proarrhythmic effects and toxicity. - **Statins**: Amiodarone can increase statin levels (e.g., simvastatin), raising the risk of muscle toxicity, including rhabdomyolysis. - **Alcohol**: Excessive alcohol intake can exacerbate the hepatic side effects of amiodarone, increasing the risk of liver damage.

Pregnancy Category Note

Information not available

Adult Dose

- **Initial Dosage**: - The initial loading dose for amiodarone is typically 150 mg IV over 10 minutes, followed by 1 mg/min for the next 6 hours. - **Maintenance Dose**: - After the initial loading phase, the usual oral maintenance dose is 200-400 mg once or twice daily, depending on the patient's response and condition. - For chronic maintenance, a dose range of 100-400 mg per day is typically used. The dosage should be adjusted based on the patient’s clinical condition and response. - **Adjustments**: - The dose may need to be reduced in patients with liver or kidney dysfunction or when interacting drugs are used that alter amiodarone metabolism.

Child Dose

- **For Pediatric Patients**: - The safety and efficacy of amiodarone in children have not been fully established, and pediatric use should generally be limited to cases where other treatment options have failed. - The typical dose for pediatric patients is based on body weight and clinical condition. For example, a loading dose of 5 mg/kg IV for 1 hour, followed by a maintenance infusion of 2-5 mg/kg/day may be used, with adjustments based on the child’s response. - Long-term oral maintenance dosing in children should be adjusted according to therapeutic response, with careful monitoring for side effects, especially thyroid and lung toxicity.

Renal Dose

- **Renal Impairment**: - Amiodarone is not primarily eliminated by the kidneys, so dose adjustments are typically not required in patients with renal impairment. However, careful monitoring is essential for patients who are also taking other drugs that may affect kidney function or when using high doses.

Administration

Information not available