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Cordarone (AMIODARONE) is an antiarrhythmic agent and is used to help your heart to beat regularly. Because this drug can have significant side-effects, this is a medicine that is used when irregular heartbeats have not responded to other medicines. It is usually reserved for treating potentially life-threatening heartbeat problems.

Common uses

• Fast, abnormal heart rhythms (tachyarrhythmias) associated with Wolff-Parkinson-White syndrome
• Fast, abnormal heart rhythms (tachyarrhythmias), including supraventricular, nodal and ventricular tachycardias, atrial fibrillation, atrial flutter and ventricular fibrillation, when other drugs cannot be used.

Before using

Your health care provider needs to know if you have any of these conditions:
•other heart problems
•liver disease
•thyroid disease
•lung disease
•low blood potassium or magnesium levels
•an unusual or allergic reaction to amiodarone, iodine, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding

Directions

• Take Cordarone Tablets exactly as prescribed by your doctor.
• The dose of Cordarone Tablets you take has been specially chosen for you by your doctor and may change during treatment. Keep taking your medicine until your doctor tells you to stop. Do not stop taking it because you feel better. Your condition may get worse. Talk with your doctor if you have side effects.
• Your doctor will tell you to take your dose of Cordarone Tablets with or without meals. Make sure you take Cordarone Tablets the same way each time.
• Do not drink grapefruit juice during treatment with Cordarone Tablets. Grapefruit juice affects how Cordarone is absorbed in the stomach.
• Taking too many Cordarone Tablets can be dangerous. If you take too many Cordarone Tablets, call your doctor or go to the nearest hospital right away. You may need medical care right away.
• If you miss a dose, do not take a double dose to make up for the dose you missed. Continue with your next regularly scheduled dose.

Cautions

• Do not drink grapefruit juice during treatment with Cordarone Tablets. Grapefruit juice affects how Cordarone is absorbed in the stomach.
• Avoid exposing your skin to the sun or sun lamps. Cordarone Tablets can cause a photosensitive reaction. Wear sun-block cream or protective clothing when out in the sun.
• Avoid pregnancy during treatment with Cordarone Tablets. Cordarone can harm your unborn baby.
• Do not breastfeed while taking Cordarone Tablets. Cordarone passes into your milk and can harm your baby.

Possible side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
• Micro-deposits in the protective outer layer of the eye (corneal microdeposits), reversible on withdrawal of treatment, which can cause drivers to be dazzled by headlights at night.
• Abnormal reaction of the skin to light, usually a rash (photosensitivity)
• Reversible grey/blueish tint to skin exposed to light, particularly the face
• Nausea and vomiting
• Metallic taste
• Slower than normal heart beat (bradycardia)
• Interference with functioning of the thyroid gland (over or under activity)
• Difficulty in sleeping (insomnia)
• Nightmares
• Lung disorders such as inflammation or scarring and stiffening causing breathlessness
• Tremor
• Fatigue
• Disorder of the peripheral nerves causing weakness and numbness (peripheral neuropathy)
• Disorder of the muscles (myopathy)
• Hair loss (alopecia)
• Headache
• Balance problems involving the inner ear (vertigo)
• New or worsening abnormal heartbeat
• Inflammation of the epididymis which has spread to involve the testis (epididymo-orchitis)
• Impotence
• Liver problems
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

If you take too much

• Seek emergency medical attention if an overdose is suspected.
• Symptoms of an Cordarone overdose include tiredness, dizziness, confusion, a slow heart rate, yellowing of the skin or eyes, diarrhea, abdominal pain, and worsening irregular heartbeats.

Additional information

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
• This medicine should not be used during pregnancy as it may be harmful to the unborn baby. Seek medical advice from your doctor.
• This medicine passes into breast milk and women taking this medicine should therefore not breastfeed. Seek medical advice from your doctor.

Drug interactions

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

The following medicines may increase the risk of a 'prolonged QT interval' on the heart monitoring trace (ECG) if they are taken in combination with amiodarone. As this could increase the risk of an irregular heartbeat called Torsades de Pointes, these medicines must not be taken with amiodarone:
• other anti-arrhythmics, eg disopyramide, procainamide, quinidine, sotalol, bretylium
• intravenous injection of the antibiotics erythromycin, pentamidine or co-trimoxazole
• tricyclic antidepressants, eg doxepin, amitriptyline
• lithium
• maprotiline
• the antihistamines terfenadine, astemizole and mizolastine
• antimalarials, eg chloroquine, quinine, mefloquine, halofantrine
• certain antipsychotics, eg chlorpromazine, thioridazine, fluphenazine, pimozide, haloperidol, amisulpiride and sertindole.
There is an increased risk of slowed conduction of electrical signals within the heart and a slow heart rate if amiodarone is used with the following; these medicines are not recommended in combination with amiodarone:
• beta-blockers such as propranolol
• the calcium channel blockers diltiazem and verapamil.
The following medicines are not recommended for use in combination with amiodarone because they may lower the amount of potassium or magnesium in the blood, which could increase the risk of side effects on the heart:
• stimulant laxatives, eg senna
• diuretics
• corticosteroids by mouth or injection
• tetracosactide
• intravenous amphotericin.
Amiodarone may increase the blood levels of the following medicines and their dose may therefore need to be reduced if they are used in combination with amiodarone:
• anticoagulants such as warfarin
• ciclosporin
• digoxin
• flecainide
• phenytoin.