Cordarone: Advanced Antiarrhythmic Therapy for Cardiac Stability
| Product dosage: 100mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $1.51 | $45.43 (0%) | 🛒 Add to cart |
| 60 | $1.35 | $90.86 $80.77 (11%) | 🛒 Add to cart |
| 90 | $1.18 | $136.29 $106.00 (22%) | 🛒 Add to cart |
| 120 | $1.09 | $181.72 $131.24 (28%) | 🛒 Add to cart |
| 180 | $1.01 | $272.58 $181.72 (33%) | 🛒 Add to cart |
| 270 | $0.95 | $408.87 $257.44 (37%) | 🛒 Add to cart |
| 360 | $0.88
Best per pill | $545.16 $318.01 (42%) | 🛒 Add to cart |
| Product dosage: 200mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 10 | $4.04 | $40.38 (0%) | 🛒 Add to cart |
| 20 | $3.53 | $80.77 $70.67 (13%) | 🛒 Add to cart |
| 30 | $3.20 | $121.15 $95.91 (21%) | 🛒 Add to cart |
| 60 | $2.94 | $242.30 $176.67 (27%) | 🛒 Add to cart |
| 90 | $2.80 | $363.44 $252.39 (31%) | 🛒 Add to cart |
| 120 | $2.65 | $484.59 $318.01 (34%) | 🛒 Add to cart |
| 180 | $2.52 | $726.89 $454.30 (38%) | 🛒 Add to cart |
| 270 | $2.32 | $1090.33 $625.93 (43%) | 🛒 Add to cart |
| 360 | $2.02
Best per pill | $1453.77 $726.89 (50%) | 🛒 Add to cart |
Cordarone (amiodarone hydrochloride) is a potent Class III antiarrhythmic agent indicated for the management of severe ventricular and supraventricular arrhythmias. With a unique pharmacological profile combining sodium channel blockade, beta-adrenergic inhibition, and potassium channel prolongation, it offers a multifaceted approach to rhythm control. Its high efficacy in treatment-resistant cases, coupled with a long half-life permitting once- or twice-daily dosing, makes it a cornerstone therapy in cardiology. However, its use requires careful patient selection and monitoring due to significant adverse effect potential.
Features
- Active ingredient: Amiodarone hydrochloride
- Available formulations: Oral tablets (200 mg), intravenous solution
- Mechanism: Multichannel blocker (sodium, potassium, calcium) with noncompetitive alpha- and beta-adrenergic inhibition
- Bioavailability: Approximately 50% for oral administration
- Half-life: Extremely long (up to 100 days with chronic use)
- Metabolism: Hepatic, via CYP3A4 and CYP2C8
- Excretion: Primarily biliary; not dialyzable
Benefits
- Effective suppression of life-threatening ventricular arrhythmias, including ventricular tachycardia and fibrillation
- Restoration and maintenance of sinus rhythm in atrial fibrillation and flutter
- Reduced hospitalization rates due to arrhythmia recurrence
- Flexible administration routes (oral and IV) allowing for acute and chronic management
- Once-daily maintenance dosing improving adherence
- Demonstrated efficacy in patients with structural heart disease, including post-MI and heart failure populations
Common use
Cordarone is primarily prescribed for rhythm control in recurrent, hemodynamically unstable ventricular tachyarrhythmias when other agents have failed or are contraindicated. It is also used for pharmacological cardioversion and maintenance of sinus rhythm in symptomatic atrial fibrillation, particularly in patients with left ventricular dysfunction. Off-label uses include postoperative arrhythmia prophylaxis and treatment in pediatric populations with refractory arrhythmias, though with heightened monitoring requirements.
Dosage and direction
Loading phase: 800–1600 mg/day orally in divided doses for 1–3 weeks, or IV infusion of 150 mg over 10 minutes followed by 360 mg over 6 hours, then 540 mg over 18 hours.
Maintenance: Typically 200–400 mg orally once daily. Lower doses (100–200 mg/day) may be used long-term in elderly or sensitive patients.
Dosage must be individualized based on therapeutic response, side effects, and serum levels when available. IV-to-oral transition should maintain equivalent total daily dosing. Regular ECGs to monitor QTc interval are mandatory.
Precautions
- Baseline and periodic ophthalmologic exams due to risk of optic neuropathy/neuritis
- Pulmonary function tests and chest X-ray before and during therapy; monitor for dyspnea or cough
- Liver enzyme and thyroid function tests every 6 months
- Skin protection from sunlight due to photosensitivity
- Avoid abrupt withdrawal; taper under supervision
- Use caution in patients with electrolyte imbalances, particularly hypokalemia or hypomagnesemia
- Not recommended as first-line therapy due to toxicity profile
Contraindications
- Severe sinus-node dysfunction or second- or third-degree AV block without pacemaker
- Cardiogenic shock
- Known hypersensitivity to amiodarone or iodine
- Severe hepatic impairment
- Concurrent use of drugs that prolong QT interval or cause torsades de pointes
- Pregnancy (except life-threatening situations) and breastfeeding
Possible side effect
Common: Corneal microdeposits (nearly universal, usually asymptomatic), photosensitivity, nausea, fatigue.
Serious: Pulmonary toxicity (fibrosis, pneumonitis), hepatotoxicity (elevated transaminases, cirrhosis), hypothyroidism or hyperthyroidism, peripheral neuropathy, blue-gray skin discoloration.
Cardiac: Bradycardia, QT prolongation (rarely torsades de pointes).
Other: Taste disturbances, tremor, insomnia.
Drug interaction
- Increases levels of warfarin, digoxin, statins, cyclosporine, and many CYP3A4 substrates
- Enhanced bradycardia with beta-blockers or calcium channel blockers
- QT prolongation with fluoroquinolones, antipsychotics, antidepressants
- Reduced amiodarone metabolism by CYP inhibitors (e.g., cimetidine)
- Amiodarone inhibits P-glycoprotein, affecting dabigatran, rivaroxaban
- Avoid concomitant use with sildenafil in pulmonary hypertension
Missed dose
If a dose is missed, take it as soon as remembered unless it is nearly time for the next dose. Do not double the dose. Given the long half-life, occasional missed doses are unlikely to significantly affect therapeutic efficacy, but consistent adherence is important for stable plasma levels.
Overdose
Symptoms include bradycardia, AV block, hypotension, cardiogenic shock, hepatic injury, and QT prolongation. Management is supportive: administer IV fluids, vasopressors, and temporary pacing if needed. Charcoal may be effective if recent ingestion. Hemodialysis is not useful. Treat arrhythmias with magnesium, isoproterenol, or pacing; avoid other antiarrhythmics.
Storage
Store at room temperature (15–30°C) in original container, protected from light and moisture. Keep IV solution in amber bag during administration. Do not freeze. Keep out of reach of children.
Disclaimer
This information is for educational purposes and does not replace professional medical advice. Cordarone is a prescription medication requiring careful supervision by a cardiologist. Individual response and risks vary; always follow your healthcare provider’s instructions regarding use, monitoring, and follow-up. Report any new symptoms promptly.
Reviews
“Cordarone has been transformative for our refractory VT patients, though we maintain rigorous screening for pulmonary and thyroid effects.” – Cardiology Dept., University Hospital
“Effective but demanding: requires multidisciplinary management and patient education on sun avoidance and symptom reporting.” – Clinical Pharmacologist
“Despite its toxicity profile, remains invaluable for high-risk arrhythmias where other options fail.” – Electrophysiology Specialist