Hypersensitivity reaction: 0.2-0.5 mg IM, SQ every 20 minutes to 4 hours (maximum single dose: 1 mg). Emergency Data sources include IBM Watson Micromedex (updated 1 May 2023), Cerner Multum (updated 17 Apr 2023), ASHP (updated 10 Apr 2023) and others. Renal Dosing: CRCL <10 ml/minute: Decrease usual dose by 25% to 50% in severe renal impairment. Maintenance infusion: 540 mg over the REMAINING 18 hours (0.5 mg/min). Hypotension One meta-analysis of 13 studies of patients with congestive heart failure or recent myocardial infarction showed a small reduction in total annual mortality, from 12.3 percent to 10.9 percent (absolute risk reduction [ARR], 2.4 percent; number needed to treat [NNT], 42).5 [Evidence level A, meta-analysis] The benefit of amiodarone therapy was more pronounced in the patients who had congestive heart failure, with treatment reducing the annual mortality rate from 24.3 percent to 19.9 percent (ARR, 4.4 percent; NNT, 23). Consider stopping amiodarone; causal relationship is uncertain. A meta-analysis11 of double-blind trials found the frequency of adult respiratory distress syndrome to be 1 percent annually. If liver enzyme levels are three times higher than normal, amiodarone should be discontinued unless a patient is at high risk for recurrence of life-threatening arrhythmia.2. Patients with the indicated arrhythmias must be hospitalized while the loading dose is given, and a response generally requires at least one week, usually two or more. Amiodarone is generally considered a class III antiarrhythmic drug, but it possesses electrophysiologic characteristics of all four Vaughan Williams classes. % Because phlebitis may occur, the drug should be given through a central venous line when possible. Amiodarone : I.V. DOSE RECOMMENDATIONS -- FIRST 24 HOURS -- Loading infusions. The recommended starting dose of Cordarone I.V. is about 1000 mg over the first 24 hours of therapy, delivered by the following infusion regimen: First Rapid: 150 mg over the FIRST - 10 minutes (15 mg/min). Add 3 mL of Cordarone I.V. (150 mg) to 100 mL D5W. }v~/lceM-. Dosing (adults): Arrhythmias: Oral: Initial: 200 mg every 8 hours with food (may load with 400 mg if necessary); adjust dose every 2-3 days; usual dose: 200-300 mg every 8 hours; maximum: 1.2 g/day (some patients respond to every 12-hour dosing). Cordarone I.V is not intended for maint therapy. 2 0 obj Treatment with Class I or III antiarrhythmics (e.g., amiodarone, flecainide, propafenone, quinidine, disopyramide, dofetilide, sotalol) or drugs that are strong inhibitors of CYP3A (e.g., ketoconazole) must be stopped before starting MULTAQ, HOW SUPPLIED MULTAQ 400-mg tablets are provided as white film-coated tablets for oral administration, oblong-shaped, engraved with a double wave marking on one side and "4142" code on the other side in:Bottles of 60 tablets, NDC 0024-4142-60 Bottles of 180 tablets, NDC 0024-4142-18 Bottles of 500 tablets NDC 0024-4142-50 Box of 10 blisters (10 tablets per blister) NDC 0024-4142-10.
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