Amiodarone (Cordarone) is a little scary because it has a 45 day half life. This meant if you became toxic on this drug, you’d be toxic on this drug for 45 days.  We had issues with this drug when it first came out on the market. As time went on, we learned that we didn’t need high doses and we could get away with relatively much lower doses and still treat the arrhythmia. Once we realized that this drug was relatively safe to use, manufacturers came out with an injectable form.
Amiodarone is reserved for ventricular arrhythmia when nothing else works. Those situations where a patient is in an ICU and lidocaine/procainamide don’t work, amiodarone may work. In fact, in some guidelines they recommend this drug nowadays as the first drug because we know how to use it better.
Adverse reactions?
- Cataract after long term use
- Pulmonary fibrosis
- Hypothyroid
