Precautions and Warnings With Amiodarone

Specific Amiodarone Precautions and Warnings

Some warnings and precautions to be aware of prior to using this drug include the following:
  • Amiodarone injections may cause a significant and potentially life-threatening drop in blood pressure (hypotension) and heart rate (bradycardia). The risk for these reactions is higher if the infusion (a slow injection into a vein) is given too quickly. If you develop hypotension or bradycardia, your healthcare provider will give you the infusion more slowly, or stop the medication altogether. You may need additional medicines to bring your blood pressure back to normal or a pacemaker to help control your heartbeat.
  • In a clinical study, people who took certain antiarrhythmia medicines like amiodarone after having a heart attack had a higher risk of their heart stopping and death than people who did not take the antiarrhythmia medication. It is unknown whether people who have not had a recent heart attack have the same risks.
  • Because of the potential risks associated with using this medication, and because it has not been shown to help people with arrhythmias live longer, amiodarone should only be used to treat life-threatening heart rhythm problems in people who did not tolerate or who were not adequately treated with other medicines.
  • You will need to begin treatment with this medicine in the hospital, where you can be closely monitored for any potential problems. You may need to stay in the hospital for one to three weeks, or occasionally longer.
  • Amiodarone has been reported to cause liver injury that, in some cases, caused death. Let your healthcare provider know right away if you have symptoms of liver problems, such as:
    • Dark urine
    • Yellowing of the skin or whites of the eyes (jaundice)
    • Pain in the upper-right area of the abdomen (stomach)
    • Nausea
    • Vomiting
    • Extreme tiredness.
  • Like other antiarrhythmia medicines, amiodarone could worsen your existing heart rhythm problem or cause a different heart rhythm problem, including a potentially life-threatening abnormal heart rhythm known as torsades de pointes. Let your healthcare provider know if you experience any abnormal heart rates during treatment, such as a fast, slow, pounding, or irregular heartbeat.
  • This medication can cause serious and potentially life-threatening lung problems. Your healthcare provider will get a chest x-ray and check how well your lungs are working before you begin taking amiodarone tablets, and every three to six months during treatment. Tell your healthcare provider right away if you experience any lung problems, such as:
    • Shortness of breath
    • Wheezing
    • Coughing
    • Chest pain
    • Coughing up blood.
  • Amiodarone has been reported to cause vision problems that, in some cases, led to permanent blindness. You should have regular eye exams while taking this medicine. Let your healthcare provider know right away if you develop vision problems, such as:
    • Blurred vision
    • Seeing halos
    • Problems with peripheral vision
    • Sensitivity to the light.
  • Amiodarone treatment should be managed by a healthcare provider who has experience treating life-threatening arrhythmias and in prescribing amiodarone. He or she should have access to the appropriate medical facilities needed to adequately monitor how well treatment is working and if any side effects are occurring.
  • This medicine can cause serious thyroid problems, including an under- or overactive thyroid (hypothyroidism or hyperthyroidism, respectively). Your healthcare provider will check your thyroid function using a blood test before and periodically during treatment. Let your healthcare provider know immediately if you develop signs of thyroid problems, such as:
    • Weakness
    • Unexplained weight loss or weight gain
    • An intolerance to hot or cold temperatures
    • Thinning of your hair
    • Sweating
    • Changes in your menstrual period
    • Swelling in your neck
    • Tremors
    • Feelings of nervousness, restlessness, or irritability
    • Problems concentrating.
  • If you are having surgery, including eye or dental surgery, it is very important to tell your healthcare provider that you are taking, or have recently taken, amiodarone, even if you stopped taking it months ago. You will need to be monitored more closely than usual, as you may be more sensitive to general anesthesia. In addition, many laser eye surgeries cannot be performed on people taking amiodarone.
  • If you have a pacemaker, it will need to be monitored and possibly reprogrammed during and after amiodarone treatment.
  • In rare cases, some people who took amiodarone developed nerve problems associated with numbness, tingling, and feelings of "pins and needles" in the hands, legs, or feet. Let your healthcare provider know right away if you experience any nerve problems, such as:
    • Lack of coordination
    • Difficulty walking
    • Uncontrollable movements.
  • You may be more sensitive to the sun during treatment. Your skin may also turn a bluish-gray color, especially after exposure to the sun. Although skin color usually returns to normal after stopping amiodarone, for some people the change in skin color is permanent. Try to avoid exposure during treatment. Make sure to wear sunscreen and protective clothing when you are out in the sun.
  • Amiodarone stays in your body for months after you stop taking it. Therefore, you may continue to have side effects even when you are no longer taking the medicine.
  • Amiodarone is a pregnancy Category D medication. This means that it may harm an unborn child (see Amiodarone and Pregnancy).
  • Amiodarone passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Amiodarone and Breastfeeding).
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