Cordarone: Advanced Antiarrhythmic Therapy for Heart Rhythm Control
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| Product dosage: 200mg | |||
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Cordarone (amiodarone hydrochloride) is a potent Class III antiarrhythmic agent indicated for the management of severe ventricular and supraventricular arrhythmias. With a unique pharmacokinetic profile and multifaceted electrophysiological effects, it remains a cornerstone therapy in cardiology for treatment-resistant cases. Its high efficacy stems from prolonging the action potential duration and refractory period across cardiac tissue, offering robust rhythm stabilization even where other antiarrhythmics fail. Proper clinical oversight is essential due to its complex safety profile.
Features
- Contains amiodarone hydrochloride as the active pharmaceutical ingredient
- Available in oral tablet and intravenous formulations
- Exhibits mixed Class I, II, III, and IV antiarrhythmic properties
- Long elimination half-life (up to 100 days) supports sustained therapeutic effect
- High tissue penetration, particularly in the heart, liver, lungs, and fat
- Requires careful titration and monitoring under specialist supervision
Benefits
- Effectively restores and maintains normal sinus rhythm in life-threatening ventricular arrhythmias
- Reduces frequency of hospitalization due to recurrent atrial fibrillation or flutter
- Provides therapeutic option when other antiarrhythmics are contraindicated or ineffective
- Oral and IV formulations allow for flexible inpatient and outpatient management
- Long half-life supports once- or twice-daily dosing after loading phase
- May improve quality of life by reducing symptomatic arrhythmia episodes
Common use
Cordarone is primarily indicated for the treatment of recurrent hemodynamically unstable ventricular tachycardia and fibrillation, particularly in patients with structural heart disease. It is also used in the management of symptomatic atrial fibrillation and flutter unresponsive to other agents, as well as for rhythm control in post-cardiac surgery settings. Its use is generally reserved for arrhythmias that are life-threatening or significantly symptomatic due to its substantial side effect profile.
Dosage and direction
Oral administration: Initiate with a loading dose of 800–1600 mg/day divided in 2–3 doses for 1–3 weeks, then reduce to 600–800 mg/day for one month. Maintenance dose is typically 200–400 mg once daily.
IV administration: Administer 150 mg over 10 minutes, followed by 360 mg over next 6 hours, then 540 mg over remaining 18 hours. Continue with maintenance infusion of 0.5–1 mg/min.
Dosage must be individualized based on clinical response, tolerance, and monitoring parameters. Always titrate to the lowest effective dose.
Precautions
- Baseline and periodic thyroid, liver, and pulmonary function tests are mandatory
- Ophthalmologic examinations recommended due to risk of optic neuropathy or neuritis
- Monitor for signs of pulmonary toxicity (dyspnea, cough, fever)
- Skin protection from sun exposure advised due to photosensitivity
- Use caution in patients with electrolyte imbalances, particularly hypokalemia or hypomagnesemia
- Electrocardiographic monitoring required due to risk of QT prolongation and proarrhythmia
Contraindications
- Severe sinus-node dysfunction or second- or third-degree AV block without pacemaker
- Known hypersensitivity to amiodarone, iodine, or any component
- Cardiogenic shock
- Marked sinus bradycardia
- Concurrent use of drugs that prolong QT interval and pose risk of torsades de pointes
- Thyroid dysfunction unless no alternative therapy exists
Possible side effect
- Corneal microdeposits (nearly universal; rarely affects vision)
- Photosensitivity, blue-gray skin discoloration
- Pulmonary fibrosis or inflammation
- Hypothyroidism or hyperthyroidism
- Hepatotoxicity ranging from elevated enzymes to cirrhosis
- Neurologic effects: peripheral neuropathy, tremor, sleep disturbances
- Bradycardia, QT prolongation, heart block
Drug interaction
- Increases levels of warfarin, digoxin, statins, and many beta-blockers
- Potentiates QT-prolonging agents (e.g., fluoroquinolones, antipsychotics)
- Interacts with CYP3A4 inducers and inhibitors
- Concomitant use with dronedarone is contraindicated
- May enhance bradycardic effects of calcium channel blockers
Missed dose
If a dose is missed, take it as soon as remembered unless it is nearly time for the next dose. Do not double the dose. Maintain regular dosing schedule. Consult healthcare provider if multiple doses are missed.
Overdose
Symptoms may include bradycardia, hypotension, QT prolongation, AV block, hepatotoxicity, and cardiogenic shock. Management is supportive: administer IV fluids, inotropic agents, or temporary pacing as needed. Hemodialysis is not effective due to high protein binding and tissue distribution.
Storage
Store at room temperature (15–30°C) in a tightly closed container. Protect from light and moisture. Keep out of reach of children. Do not use after expiration date.
Disclaimer
This information is intended for healthcare professionals. Cordarone should only be prescribed by physicians experienced in the treatment of life-threatening arrhythmias. Patients must be fully informed of risks and benefits. Regular monitoring is essential to ensure safe use.
Reviews
“Cordarone has been invaluable in managing recurrent ventricular tachycardia in our cardiomyopathy patients, though it demands vigilant monitoring.” – Cardiology Dept., University Hospital
“While highly effective for persistent AF, the side effect profile requires careful patient selection and ongoing assessment.” – Clinical Pharmacologist
“Despite its complexities, amiodarone remains a vital option for arrhythmias refractory to first-line treatments.” – Heart Rhythm Specialist