Last Updated on June 3, 2023
Unfortunately, amiodarone hydrochloride is not available over the counter in the UK. It is a prescription drug that is used to treat certain heart conditions such as arrhythmias. In order to obtain this medication, you will need to consult with a doctor or other medical professional who can assess your condition and determine if this drug is appropriate for you.
Amiodarone hydrochloride is a potent medication and can cause serious side effects if not taken correctly. This is why it is important to have a medical professional involved in the prescribing and monitoring of this drug. Taking amiodarone hydrochloride without proper medical supervision can lead to dangerous complications, such as lung damage, liver toxicity, and thyroid problems.
If you are experiencing symptoms of a heart condition or have been diagnosed with an arrhythmia, it is important to seek medical attention as soon as possible. Your doctor can provide you with information on treatment options, including the use of medications like amiodarone hydrochloride. While it may be tempting to try and obtain this medication over the counter, it is important to remember that doing so can be dangerous and potentially life-threatening. Always follow the advice of your doctor and take medications only as prescribed.
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What is amiodarone?
Amiodarone is used to treat heart rhythm problems. The drug was developed in 1961 and is now found in many medicines. It is widely considered to be very effective, but it can cause serious side effects. For this reason, amiodarone is only used as a second-line treatment for cardiac arrhythmias. You can read all about amiodarone here.
Mechanism of action
For the heart muscle to pump blood regularly through the body, its cells need to be stimulated evenly. This excitation is formed between the back. These processes are called ion channels: During excitation and repolarisation, certain charged particles (ions) flow into and out of the cells.
When the heart rhythm (arrhythmia) is disturbed, this regular alternation between excitation and de-excitation is disrupted: as a result, the heart muscle can no longer contract rhythmically – an irregular heartbeat is the result. If such irregularities occur frequently, the body is no longer supplied with sufficient blood. Treatment with antiarrhythmics (medicines to treat heart rhythm problems) may then be necessary.
An example of an antiarrhythmic drug is amiodarone. Amiodarone blocks several ion channels (potassium, sodium and calcium channels), preventing the heart muscle from becoming too excited. This normalises the heart rate.
Amiodarone hydrochloride is absorbed from the intestine into the blood in varying amounts (25-80 percent). It is then broken down in the liver and excreted mainly in the faeces.
Because the drug accumulates in fatty tissue, it can take up to 100 days after stopping the drug for amiodarone to be completely cleared from the body.
When is amiodarone used?
The active ingredient is amiodarone, which is used to treat cardiac arrhythmias (such as atrial fibrillation) when other anti-arrhythmic drugs are ineffective or cannot be used.
How is amiodarone used?
Amiodarone can be injected in acute cases, but is usually given as tablets.
The dose is 600-1000 milligrams daily for the first eight to ten days. After that, the daily dose is gradually reduced to 100-200 milligrams.
Reason for this procedure: Amiodarone accumulates in fatty tissue. However, only part of the active ingredient in the blood is effective, so at the start of treatment an “amiodarone saturation” of the fatty tissue is necessary. This is also the reason why the effect is felt after about two weeks.
This particular “distribution” of the drug in the body requires regular dose monitoring by the doctor, especially in elderly patients.
What are the side effects of amiodarone?
Very often, in more than ten per cent of patients, amiodarone can cause side effects such as rashes and blurred vision due to deposits on the cornea.
Frequently (in one to ten percent of patients): black violet, reversible skin discolouration, thyroid disorders, tremors, insomnia, slowed heartbeat (bradycardia), low blood pressure (hypotension), muscle weakness and lung changes with unproductive and breathing difficulties.
Occasionally (ie less than one percent of patients), the intake of amiodarone to reduced sexual desire (libido), arousal disorders of the heart, fatigue and gastrointestinal symptoms. More rarely, renal dysfunction may occur.
What should I watch for while taking amiodarone?
In some cases, amiodarone should not be used:
- low pulse (less than 55 beats per minute, known as “Brady”)
- all forms of delay in the conduction of the heart (e.g. atrioventricular block), unless a pacemaker is used
- thyroid diseases
- iodine allergies
- certain changes in the electrocardiogram (QT prolongation)
- low potassium levels
- concomitant treatment with so-called MAO inhibitors such as tranylcypromine, moclobemide, selegiline and rasagiline
- co-administration of (at excessively high cholesterol levels), if the daily dose exceeds 20 milligrams
- pregnancy and lactation
Pregnancy and lactation
Amiodarone should only be used by pregnant women in emergencies, as there is some evidence that it may harm the unborn child. However, there is very little data on the use of amiodarone during pregnancy.
If pregnancy is planned, amiodarone should be stopped six months before conception so that there is no amiodarone left in the body at the time of conception.
If breast-feeding is unavoidable or if amiodarone has been taken during pregnancy, the baby should not be breast-fed as the drug is excreted in human milk.
There is not enough experience to use this medicine in children and adolescents. Treatment should only be given after a rigorous risk-benefit assessment by the doctor.
While you are taking amiodarone, your skin is particularly sensitive to light (“photosensitising”). You should therefore avoid sunbathing.
Because amiodarone is cleared very slowly from the body, interactions with other drugs are expected for up to six months after stopping the drug.
Amiodarone increases the effects and side effects of the following medicines:
- warfarin (blood-thinning drug)
- phenytoin (medicines)
- diltiazem, verapamil (for cardiac arrhythmias,)
- cyclosporin, Tacrolimus (suppress the immune system, such as after transplants or in autoimmune diseases)
- fentanyl (strong painkiller)
- cholesterol-lowering drug (statin)
- sildenafil (for impotence)
- midazolam (for anesthesia)
- triazolam (sleeping pills)
- dihydroergotamine, ergotamine (for migraine)
- flecainide (for arrhythmia)
The following substances increase the effect of amiodaron:
- digitalis (for heart disorders)
- medicines for HIV
- grapefruit Juice
When co-administered the following drugs and Amiodarone can cause a potentially life threatening cardiac arrhythmia (“torsades de pointes tachycardia”) are:
- other antiarrhythmics
- certain active ingredients against bacterial, parasitic and fungal infections (erythromycin, cotrimoxazole, pentamidine, moxifloxacin)
- drugs to treat mental illness (lithium, tricyclic antidepressants, chlorpromazine, thioridazine, fluphenazine, pimozide, haloperidol, amisulpride)
- antimalarial (quinine, mefloquine, chloroquine)
- cisapride (for stomach ulcers)
Laxatives, diuretics, glucocorticoids (“cortisone”) or amphotericin B (antifungal) cause low blood potassium levels. Co-administration with amiodarone may also lead to torsade de pointes tachycardia or other abnormal heart rhythms.
Driving and using machines
Even with correct dosage, amiodarone can strongly affect reactivity. Experts therefore recommend that you do not drive or use heavy machinery during treatment.
How to get amiodarone?
Amiodarone is a highly effective medicine that needs to be monitored regularly by your doctor. For this reason, amiodarone is only available from pharmacies on prescription.
How long has amiodarone been on the market?
Amiodarone was developed in 1961, but chemically optimised drugs with fewer side effects are now available. Amiodarone is therefore only used as a second choice drug to control heart rhythm.