ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Antiarrhythmic Pregnancy: D — use only for life-threatening arrhythmia in pregnancy

Amiodarone

Brand names: Cordarone X

Adult dose

Dose: VF/pVT arrest: 300mg bolus. Stable VT: 150mg over 10 min
Route: IV / IO
Frequency: Single bolus in arrest; then infusion for stable arrhythmias
Max: 2.2g in first 24 hours
Cardiac arrest (VF/pVT after 3rd shock): 300mg IV bolus. Recurrent VF: additional 150mg. Stable VT or AF rate control: 150mg IV over 10 min, then 1mg/min for 6h, then 0.5mg/min. Dilute in 5% glucose (NOT saline).

Paediatric dose

Dose: 5 mg/kg
Route: IV / IO
Frequency: Single bolus (arrest)
Max: 300mg
Concentration: 50 mg/ml

Dose adjustments

Renal

No adjustment required.

Hepatic

Use with caution — primarily metabolised hepatically.

Paediatric weight-based calculator

Clinical pearls

  • Dilute in 5% glucose ONLY — precipitates in saline.
  • Peripheral infusion causes phlebitis. Acceptable for arrest bolus peripherally. Use central access for infusions lasting >4h.
  • Half-life 40–55 days — drug interactions persist for weeks after stopping.
  • Paed cardiac arrest: 5mg/kg IO/IV bolus after 3rd shock.

Contraindications

  • Sinus bradycardia and sinoatrial block (without pacemaker)
  • Severe conduction defects (without pacemaker)
  • Iodine hypersensitivity
  • Thyroid dysfunction (relative — use in arrest)
  • Pregnancy (relative — use for life-threatening arrhythmias only)

Side effects

  • Hypotension with rapid IV administration
  • Phlebitis at peripheral IV site — use central access for infusions >4h
  • Bradycardia and AV block
  • Pulmonary toxicity (with long-term oral use)
  • Thyroid dysfunction (both hypo and hyperthyroidism)
  • Corneal microdeposits, photosensitivity (oral)

Interactions

  • Warfarin: significantly potentiates anticoagulation — reduce warfarin dose by 30–50%
  • Digoxin: raises digoxin levels — halve digoxin dose
  • Simvastatin: increased myopathy risk — cap simvastatin at 20mg
  • QT-prolonging drugs: additive Torsades de Pointes risk

Monitoring

  • ECG (PR
  • QRS
  • QTc)
  • TFTs
  • LFTs
  • CXR (with prolonged use)

Reference: BNFc; NICE BNF 84; UK Resuscitation Council 2021. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

Drugs
Pathways