Neonatal Drug Therapy Manual


Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Antiarrhythmic Agent
Original Date: 
July 2003
Revised Date: 
Dec 2023
  • Supraventricular arrhythmias such as junctional ectopic tachycardia (JET), atrial flutter, atrial tachycardia
  • Management of resistant, life-threatening ventricular arrhythmias
  • IV loading dose over 60 minutes followed by a continuous infusion
  • IV direct, intraosseous: in cardiac arrest only
  • PO
  • IV:
    • Stable Arrhythmias
      • Loading dose: 5 mg/kg/dose over 60 minutes followed by an infusion
      • Continuous infusion: 5 - 15 mcg/kg/min
      • Dilution concentration: 0.6 - 6 mg/mL (use central line if concentration > 2 mg/mL)
    •  Pulseless VF or VT
      • 5 mg/kg rapid IV bolus or intraosseous
  • PO:
    • Loading dose: 10 mg/kg/day as a single daily dose or divided BID for 7 to 10 days
    • Maintenance dose: 5 mg/kg/day as a single daily dose
Side Effects: 
  • CVS: bradycardia, heart block, hypertension (may be related to infusion rate)
  • Endocrine: hypothyroidism, hyperglycemia, increased triglycerides
  • Hematologic: coagulation abnormalities, thrombocytopenia
  • Hepatic: liver enzymes elevated, severe hepatic toxicity
  • Local: phlebitis (concentrations 2.5 mg/mL may be less irritating)
  • Ocular: corneal microdeposits, halos or blurred vision, photophobia, optic neuropathy, optic neuritis
  • Respiratory: intersitital pneumonitis, hypersensitivity pneumonitis
Parameters to Monitor: 
  • HR, BP
  • CXR
  • CBC, thyroid function tests, liver function tests
  • Ophthalmologic exams


Reconstitution and Stability: 
  • Amidarone 50 mg/mL
    • Add 0.4 mL (20 mg) of amiodarone to 19.6 mL of D5W
    • Final concentration: 1 mg/mL
  • Amiodarone 50 mg/mL
    • Add 0.8 mL (40 mg) of amiodarone to 19.2 mL of D5W
    • Final concentration: 2 mg/mL (central line only)
  • Stability: 24 hours at room temperature in IV syringes or glass bottles
  • Solutions Compatible: D5W
  • Y-site Compatible: amphotericin B, dobutamine, dopamine, epinephrine, fentanyl, gentamicin, midazolam, milrinone, morphine, vancomycin

Incompatible: SMOF, TPN


May increase serum digoxin levels - reduce digoxin dose by 50% during concurrent therapy


-Taketomo CK, Hodding JH, Kraus DM. Pediatric Dosage Handbook 9th-11th Editions. Hudson: Lexi-Comp Inc.; 2002-2004.

-Trissel LA. Handbook on Injectable Drugs. 12th-13th Editions. Bethesda: American Society of Health-System Pharmacists; 2003-2005.

-King JC. King Guide to Parenteral Admixtures. Internet Edition.

-The Children's Hospital of Eastern Ontario Parenteral Drug Manual. Department of Pharmacy 2003.

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