Dosing
Amiodarone is available in oral and intravenous formulations.
Orally, it is available under the trade names Pacerone (produced by Upsher-Smith Laboratories, Inc.) and Cordarone (produced by Wyeth-Ayerst Laboratories) in 200 mg and 400 mg tablets; It is also available under the trade name Aratac (produced by Alphapharm Pty Ltd) in 100 mg and 200 mg tablets in Australia and New Zealand, and further in Australia under the brands Cardinorm and Rithmik (both in 100mg and 200mg tablets) as well as a number of generic brands. Also Arycor in South Africa (Produced by Winthrop Pharmaceuticals.) in doses of 100 mg and 200 mg scored tablets. In South America, it is known as Atlansil and is produced by Roemmers.
In India amiodarone is marketed(produced by Cipla Pharmaceutical) under the brand name Tachyra available in 100 mg &200 mg and intravenous ampules.
It is also available in intravenous ampules and vials, typically in 150 mg increments.
The dose of amiodarone administered is tailored to the individual and the dysrhythmia that is being treated. When administered orally, the bioavailability of amiodarone is quite variable. Absorption ranges from 22 to 95%, with better absorption when it is given with food.
Amiodarone is fat-soluble, and tends to concentrate in tissues including fat, muscle, liver, lungs, and skin. This confers a high volume of distribution (5000 liters in a 70 kg adult) and a long half-life. Due to the long half-life of amiodarone, oral loading typically takes days to weeks.
An oral loading dose is typically a total of 10 grams, divided over one to two weeks but there are many other dosing regimens. Once an individual is loaded, a typical maintenance dose of amiodarone is 100 or 200 mg either once or twice daily.
An intravenous loading dose is typically 300 mg in 20-30cc 5% Dextrose solution (D5W) for cardiac arrest. The loading infusion for dysrhythmias is typically 150 mg in a 100cc bag of 5% Dextrose solution (D5W) given over 10 minutes. Both can be followed by a 360 mg slow infusion over 6 hours then a maintenance infusion of 540 mg over 18 hours.
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