Amiodarone

What is amiodarone?

Amiodarone is a heart medicine, which belongs to a group of medicines called antiarrhythmics. It helps correct fast, irregular, or uneven heartbeats.

You may hear amiodarone called by its brand name, Cordarone. Amiodarone comes in tablet and injection forms. The pharmacy at The Hospital for Sick Children makes capsules when the doctor orders a low dose.

Before giving amiodarone to your child

Tell your doctor if your child has:

• an allergy to amiodarone
• a slow heartbeat not controlled by a pacemaker

Talk with your doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• a low heartbeat
• liver disease
• thyroid problems
• lung problems

How should you give your child amiodarone?

Follow these instructions when you give your child amiodarone:

• Give your child amiodarone exactly as your doctor or pharmacist tells you to, even if your child seems better.
• Talk to your child's doctor before you change the dose or stop giving this medicine for any reason. Your child may become ill if they stop taking this medicine suddenly.
• Give amiodarone at the same times every day. Make sure you leave the same amount of time between doses.
• Give with or without food. Give it with food if it upsets the stomach.
• Do not give your child grapefruit juice or other grapefruit products.
• Amiodarone can also be given as an injection (needle) into your child's vein. This injection is given at the hospital.

What should you do if your child misses a dose?

• Give your child the missed dose as soon as you remember.
• If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
• Do not give your child two doses to make up for one missed dose.

How long does amiodarone take to work?

It may take several weeks after starting amiodarone before your child feels better.

What are the possible side effects of amiodarone?

Your child may have some of these side effects while they take amiodarone. Check with your child's doctor if your child continues to have any of these side effects, and they do not go away, or they bother your child:

• dizziness
• headache
• weakness, reduced alertness, feeling unsteady or clumsy
• constipation
• loss of appetite
• nausea and vomiting
• bitter or metallic taste in mouth
• flushing of the face

Call your child's doctor during office hours if your child has any of these side effects:

• unexplained low fever
• trembling, shaking, or unusual movements of the body
• numbness or tingling in fingers or toes
• changes in heartbeat (fast or irregular)

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to the Emergency Department if your child has any of these side effects:

• a cough that does not go away, painful breathing or shortness of breath
• severe nausea and vomiting or stomach pain
• yellowing of the eyes or skin
• fainting, severe weakness, or chest pain

After your child stops taking amiodarone, it may still cause some side effects that need attention. During this period of time, check with your doctor as soon as possible if your child has the following side effects:

• a cough that does not go away
• painful breathing
  
• shortness of breath

What safety measures should you take when your child is using amiodarone?

Keep all appointments at the clinic or doctor's office so that the doctor can check your child's reaction to amiodarone.

Your child's doctor will order blood tests to check for problems with the liver and thyroid.

There are some medicines that should not be taken together with amiodarone. In some cases, the dose of amiodarone or the other medicine may need to be adjusted. Tell your doctor or pharmacist if your child is also taking any of the following medicines:

• warfarin (Coumadin®)
• digoxin (Lanoxin®)
• phenytoin (Dilantin®)
• cyclosporine
• other heart medications (e.g., quinidine, procainamide, flecainide)
• certain antibiotics or antifungal medications

Check with your child's doctor or pharmacist before giving your child any other medicines (prescription, non-prescription, herbal, or natural products).

Amiodarone may sometimes affect eyesight. Check with your doctor if there are any changes in your child's vision. Keep any eye appointments that your doctor makes to have your child's eyes checked.

Before your child has any surgery, including dental surgery or emergency treatment, tell the doctor or dentist that your child is taking amiodarone.

Amiodarone may make your child's skin more likely to sunburn, even after they stop taking amiodarone. To help prevent sunburn:

• Avoid direct sunlight for long periods of time.
• When outside, cover your child with clothing and a hat.
• Apply a sunscreen with an SPF of 15 or higher.
• Avoid sunlamps, bright indoor lights, and tanning beds.

After your child has taken this medicine for a long time, amiodarone may cause the skin to turn a blue-gray colour (especially areas where the skin is exposed to the sun). This colour will usually fade after amiodarone is stopped, but it may take several months. Tell your doctor if this happens.

What other important information should you know about amiodarone?

• Keep a list of all medications your child is on and show the list to the doctor or pharmacist.
• Do not share your child's medicine with others and do not give anyone else's medicine to your child.
• Amiodarone capsules must be made by a pharmacy. If your child is taking amiodarone capsules, make sure your pharmacy is able to make them.
• Make sure you always have enough amiodarone to last through weekends, holidays, and vacations. Call your pharmacy at least 2 days before your child runs out of medicine to order refills.
• Keep amiodarone at room temperature in a cool, dry place away from sunlight. Do NOT store it in the bathroom or kitchen.
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
  

Keep amiodarone out of your child’s sight and reach and locked up in a safe place. If your child takes too much amiodarone, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.