Cordarone: Advanced Antiarrhythmic Therapy for Sustained Cardiac Rhythm Control
Cordarone
| Product dosage: 100mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | 1.75 $ | 52.65 $ (0%) | 🛒 Add to cart |
| 60 | 1.56 $ | 105.30 $ 93.60 $ (11%) | 🛒 Add to cart |
| 90 | 1.36 $ | 157.95 $ 122.85 $ (22%) | 🛒 Add to cart |
| 120 | 1.27 $ | 210.60 $ 152.10 $ (28%) | 🛒 Add to cart |
| 180 | 1.17 $ | 315.90 $ 210.60 $ (33%) | 🛒 Add to cart |
| 270 | 1.10 $ | 473.85 $ 298.35 $ (37%) | 🛒 Add to cart |
| 360 | 1.02 $
Best per pill | 631.80 $ 368.55 $ (42%) | 🛒 Add to cart |
| Product dosage: 200mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 10 | 4.68 $ | 46.80 $ (0%) | 🛒 Add to cart |
| 20 | 4.09 $ | 93.60 $ 81.90 $ (13%) | 🛒 Add to cart |
| 30 | 3.70 $ | 140.40 $ 111.15 $ (21%) | 🛒 Add to cart |
| 60 | 3.41 $ | 280.80 $ 204.75 $ (27%) | 🛒 Add to cart |
| 90 | 3.25 $ | 421.20 $ 292.50 $ (31%) | 🛒 Add to cart |
| 120 | 3.07 $ | 561.60 $ 368.55 $ (34%) | 🛒 Add to cart |
| 180 | 2.92 $ | 842.40 $ 526.50 $ (38%) | 🛒 Add to cart |
| 270 | 2.69 $ | 1263.60 $ 725.40 $ (43%) | 🛒 Add to cart |
| 360 | 2.34 $
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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 pharmacological profile combining sodium channel blockade, beta-adrenergic inhibition, calcium channel antagonism, and potassium channel prolongation, it offers comprehensive electrophysiological control. Its high efficacy in treatment-resistant cases and extensive tissue distribution make it a cornerstone therapy in cardiology, though it requires careful patient selection and monitoring due to its complex pharmacokinetics and potential for significant adverse effects.
Features
- Contains amiodarone hydrochloride as the active pharmaceutical ingredient
- Available in 100 mg and 200 mg tablet formulations
- Exhibits multiple antiarrhythmic class effects (I, II, III, IV)
- Long elimination half-life (approximately 58 days)
- High lipid solubility with extensive tissue distribution
- Iodine content: 75 mg per 200 mg tablet
- Bioavailability: approximately 50%
- Protein binding: 96%
Benefits
- Effectively suppresses life-threatening ventricular arrhythmias including ventricular tachycardia and fibrillation
- Maintains sinus rhythm in patients with atrial fibrillation and flutter where other agents have failed
- Reduces hospitalization rates for arrhythmia recurrence
- Demonstrates efficacy in patients with structural heart disease including post-MI and heart failure
- Provides sustained therapeutic effect due to long half-life
- Offers once-daily maintenance dosing after appropriate loading regimen
Common use
Cordarone is primarily indicated for the treatment of documented, life-threatening recurrent ventricular fibrillation and recurrent hemodynamically unstable ventricular tachycardia when these arrhythmias have not responded to adequate doses of other antiarrhythmics or when alternative agents are not tolerated. It is also used for the pharmacological conversion of atrial fibrillation to normal sinus rhythm and for maintenance of sinus rhythm after conversion in patients with significant structural heart disease. Off-label uses include rate control in atrial fibrillation and management of arrhythmias in specific patient populations such as those with hypertrophic cardiomyopathy.
Dosage and direction
Loading dose: 800-1600 mg daily in divided doses for 1-3 weeks
Maintenance dose: 400-600 mg daily for one month, then 200-400 mg daily
Intravenous administration: 150 mg over 10 minutes followed by 360 mg over 6 hours, then 540 mg over 18 hours
Dosage must be individualized based on therapeutic response, tolerance, and monitoring parameters. Grapefruit juice should be avoided due to interaction with CYP3A4 metabolism. Administration with meals may reduce gastrointestinal side effects. Regular monitoring of thyroid function, liver enzymes, and pulmonary function is mandatory during therapy.
Precautions
- Requires baseline and periodic ophthalmologic examinations due to risk of optic neuropathy
- Regular monitoring of thyroid function (TSH, T4, T3) every 3-6 months
- Pulmonary function tests and chest X-ray baseline and every 3-6 months
- Liver function tests monthly for first 6 months, then periodically
- ECG monitoring for QT interval prolongation
- Skin protection from sunlight due to photosensitivity
- Caution in elderly patients due to increased risk of adverse effects
- Regular assessment of neurological status
Contraindications
- Severe sinus-node dysfunction causing marked sinus bradycardia
- Second- or third-degree AV block unless a functioning pacemaker is present
- Cardiogenic shock
- Known hypersensitivity to amiodarone or iodine
- Pregnancy (except in life-threatening circumstances)
- Breastfeeding
- Severe hepatic impairment
- Concomitant use with drugs that prolong QT interval and risk of torsades de pointes
Possible side effect
Common (≥1%): Corneal microdeposits (virtually 100%), photosensitivity, blue-gray skin discoloration, nausea, vomiting, constipation, elevated liver enzymes, thyroid dysfunction (both hyper and hypothyroidism), tremor, sleep disorders
Serious (<1%): Pulmonary toxicity (fibrosis, pneumonitis), hepatotoxicity including cirrhosis, neuropathy, myopathy, vision loss from optic neuritis, proarrhythmic effects including torsades de pointes, bone marrow suppression, Stevens-Johnson syndrome
Drug interaction
- Warfarin: Potentiates anticoagulant effect (reduce warfarin dose by 33-50%)
- Digoxin: Increases serum concentration by 70-100%
- Beta-blockers, calcium channel blockers: Enhanced bradycardic and hypotensive effects
- Statins: Increased risk of myopathy, especially with simvastatin
- Phenytoin: Alters metabolism of both drugs
- Cyclosporine: Increases cyclosporine levels
- QT-prolonging agents: Additive risk of torsades de pointes
- CYP3A4 inhibitors/inducers: Alters amiodarone metabolism
Missed dose
If a dose is missed, take it as soon as remembered unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed dose. Maintain regular dosing schedule. Due to the long half-life of amiodarone, occasional missed doses are unlikely to significantly affect therapeutic efficacy, but consistent adherence is important for maintaining stable plasma concentrations.
Overdose
Symptoms may include bradycardia, hypotension, cardiogenic shock, AV block, hepatic injury, and QT prolongation. Management includes gastric lavage if recent ingestion, supportive care with hemodynamic monitoring, and symptomatic treatment. Bradycardia may require temporary pacing. Inotropic support may be necessary for hypotension. Hemodialysis is not effective due to extensive protein binding and tissue distribution. Contact poison control center immediately for guidance.
Storage
Store at controlled room temperature (20-25°C or 68-77°F). Protect from light and moisture. Keep in original container with tight closure. Do not store in bathroom or near sink. Keep out of reach of children and pets. Do not use after expiration date printed on packaging. Do not transfer to other containers as this may affect stability.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Cordarone is a prescription medication that should only be used under the supervision of a qualified healthcare professional. The prescribing physician should be familiar with the complete prescribing information and monitoring requirements. Patients should not initiate or discontinue therapy without medical supervision. Individual results may vary based on patient characteristics and compliance with monitoring requirements.
Reviews
Clinical studies demonstrate: In randomized controlled trials, Cordarone showed 60-70% efficacy in maintaining sinus rhythm in atrial fibrillation patients at 12 months compared to 30-40% with other antiarrhythmics. The EMIAT and CAMIAT trials showed significant reduction in arrhythmic deaths in post-MI patients with impaired ventricular function. However, up to 15% of patients require discontinuation due to adverse effects within the first year of therapy.
Expert consensus: Cardiology guidelines recommend Cordarone as a second-line agent for ventricular arrhythmias and selected cases of atrial fibrillation due to its proven efficacy but significant side effect profile. It remains particularly valuable in patients with structural heart disease where other antiarrhythmics are contraindicated. The 2019 AHA/ACC/HRS guidelines emphasize the need for thorough risk-benefit assessment before initiation and structured follow-up during therapy.