Parenteral Manual

Amiodarone

Disclaimer: Official controlled document is the CHEO 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): 
CORDARONE
Classification: 
Antiarrhythmic
Original Date: 
August 2005
Revised Date: 
June 2026
Indications: 
  • Management of resistant, life-threatening ventricular arrhythmias
  • Supraventricular arrhythmias such as junctional ectopic tachycardia (JET) unresponsive to conventional therapy
Reconstitution and Stability: 
  • Available as a 50 mg/mL solution
  • Protect from light (light protection is not necessary during administration)
  • Stable for  24 hours in syringe or 2 hours in PVC bags

Amiodarone 1 mg/mL: 

  • Draw up 50 mg (1 mL) of amiodarone 50 mg/mL and add to 49 mL of D5W 

Amiodarone 2 mg/mL (central line only):

  • Draw up 100 mg (2 mL) of amiodarone 50 mg/mL and add to 48 mL of D5W 

Amiodarone 6 mg/mL (central line only):

  • Draw up 300 mg (6 mL) of amiodarone 50 mg/mL and add to 44 mL of D5W 
Compatibility: 

- Solutions Compatible:  D5W only

- Additives/Above Cassette Compatible: potassium chloride ( up to 40 mmol/L), dobutamine, dopamine, lidocaine, procainamide, verapamil

-Y-site Compatible: ciprofloxacin, fluconazole, metronidazole, midazolam, morphine

- Incompatible: heparin, SMOF lipid 20%

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

  • SC
 NO
IM NO
IV Direct YES
Infusion time: 0.5-3 minutes (emergency treatment)
IV Intermittent Infusion YES
Usual dilution: 1 mg/mL,
                    Central line only: 2 mg/mL, 6 mg/mL
Infusion time: 30-60 minutes
IV Continuous Infusion

YES
Standard Concentration in ER/OR/PICU:  1 mg/mL,
                   Central line only: 2 mg/mL, 6 mg/mL

Administer continuous infusion (>1 hour) through a 0.22 micron in-line filter.

 

Click here to access SDC Drug Infusion Sheet

 

 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:

Tachyarrythmias

  • Loading dose:
    • 5 mg/kg/dose IV over 30 - 60 minutes followed 15 minutes later by an infusion
  • Continuous infusion:
    • 5 - 15 mcg/kg/minute IV (or 10 - 20 mg/kg/day)

Ventricular Fibrillation (VF)/Pulseless Ventricular Tachycardia 

  • 5 mg/kg IV rapid bolus (Maximum dose: 300 mg/dose), may repeat twice for a total of 15 mg/kg. 
Potential hazards of parenteral administration: 
  • Hypotension (may be related to infusion rate)
  • Bradycardia, heart block
  • Phlebitis and pain at injection site (concentrations <2.5 mg/mL may be less irritating)
  • Slate blue discoloration of skin, rash, photosensitivity
  • Increased liver enzymes, severe hepatic toxicity
  • Halos, blurred vision, corneal deposits
  • Pulmonary fibrosis, interstitial pneumonitis
  • Hypothyroidism (or hyperthyroidism - less common)
Notes: 
  • Monitor HR, blood pressure, EKG, pulmonary function tests, chest X-ray, thyroid function tests, liver enzymes, ophthalmologic exams
  • Inhibits P-450 enzymes and may increase levels of digoxin, lidocaine, cyclosporine, theophylline, procainamide, warfarin, phenytoin.  Dosage reductions may be required

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