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3 Interactions found for:

amiodarone
Interactions Summary
  • 3 Major
  • 0 Moderate
  • 0 Minor
  • amiodarone

Drug Interactions

A total of 764 medications are known to interact with amiodarone. Add another medication to view potential interactions with this medication.

Drug and Food Interactions

Major
Amiodarone + Food

The following applies to the ingredients: Amiodarone

GENERALLY AVOID: Grapefruit juice may significantly increase the plasma concentrations of orally administered amiodarone. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. In 11 nonsmoking, healthy volunteers, grapefruit juice (300 mL with drug administration, then 3 hours and 9 hours later) increased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of amiodarone (17 mg/kg single dose) by 84% and 50%, respectively, compared to water. Formation of the pharmacologically active metabolite, N-desethylamiodarone (N-DEA), was completely inhibited. Clinically, this interaction can lead to altered efficacy of amiodarone, since antiarrhythmic properties of amiodarone and N-DEA appear to differ. In the study, mean increases in PR and QTc intervals of 17.9% and 11.3%, respectively, were observed 6 hours postdose with water, while increases of 10.2% and 3.3%, respectively, were observed after administration with grapefruit juice.

ADJUST DOSING INTERVAL: Food increases the rate and extent of absorption of amiodarone. The mechanism appears to involve the effect of food-induced physiologic changes on drug release from its formulation. In 30 healthy volunteers, administration of a single 600 mg dose of amiodarone following a high-fat meal resulted in a Cmax and AUC that were 3.8 and 2.4 times the respective values under fasting conditions. The time to reach peak plasma concentration (Tmax) was decreased by 37%, indicating an increased rate of absorption. Mean Cmax and AUC for the active metabolite, N-DEA, also increased by 32% and 55%, respectively, but there was no change in the Tmax.

MANAGEMENT: Patients treated with oral amiodarone should avoid consumption of grapefruits and grapefruit juice. In addition, oral amiodarone should be administered consistently with regard to meals.

References

  1. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories PROD (2002):
  2. Libersa CC, Brique SA, Motte KB, et al. "Dramatic inhibition of amiodarone metabolism induced by grapefruit juice." Br J Clin Pharmacol 49 (2000): 373-8
  3. Meng X, Mojaverian P, Doedee M, Lin E, Weinryb I, Chiang ST, Kowey PR "Bioavailability of Amiodarone tablets administered with and without food in healthy subjects." Am J Cardiol 87 (2001): 432-5

Drug and Pregnancy Interactions

The following applies to the ingredients: Amiodarone

This drug should be used during pregnancy only if the benefit outweighs the risk to the fetus.
-According to some authorities: Use is contraindicated.

AU TGA pregnancy category: C
US FDA pregnancy category: Not assigned

Risk Summary: Use in pregnant women may increase the risk of adverse fetal effects including neonatal hypo- and hyperthyroidism, neonatal bradycardia, neurodevelopmental abnormalities, preterm birth, and fetal growth restriction. Untreated underlying arrhythmias in pregnant women pose a risk to the mother and fetus.

Comments:
-Based on animal studies, this drug may impair female and male fertility.
-Patients planning pregnancy should be advised of the long half-life associated with this drug and its metabolite.
-According to some authorities: Due to the long half-life, discontinuation several months before conception is recommended to avoid fetal exposure.
-If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential harm to the fetus.
-Advise pregnant women of the potential risk to a fetus.
-Therapeutic levels may be difficult to maintain due to the increased volume of distribution and increased drug metabolism inherent in the pregnant state.
-Risk of arrhythmias may increase during labor and delivery, monitor patients continuously during labor and delivery.
-Monitor the newborn for signs and symptoms of thyroid disorder and cardiac arrhythmias.

Animal studies have revealed evidence of embryofetal toxicity at doses less than the maximum recommended human maintenance dose. In animals, exposure during pregnancy was associated with abortions, impaired fetal growth, skeletal abnormalities, and increased fetal loss. This drug and its metabolite cross the placenta. Based on animal studies, this drug may impair female and male fertility. It is not known if this effect is reversible. There are no controlled data in human pregnancy.

Fetal/neonatal adverse reactions associated with maternal use may include neonatal bradycardia, QT prolongation, hypo- and hyperthyroidism, neurodevelopmental abnormalities, fetal growth restriction, and preterm birth.

AU TGA pregnancy category C: Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible. Accompanying texts should be consulted for further details.

US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.

References

  1. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories PROD (2002):
  2. "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  4. Cerner Multum, Inc. "Australian Product Information." O 0
  5. "Product Information. Pacerone (amiodarone)." Upsher-Smith Laboratories LLC (2023):
  6. "Product Information. Nexterone (amiodarone)." Prism Pharmaceuticals (2025):
  7. "Product Information. Amiodarone Hydrochloride (amiodarone)." Hikma USA (formerly West-Ward Pharmaceutical Corporation) (2024):

Drug and Breastfeeding Interactions

The following applies to the ingredients: Amiodarone

Breastfeeding is not recommended during use of this drug; use is contraindicated per some authorities.

Excreted into human milk: Yes

The infant receives an estimated dose of this drug plus its active metabolite between 3.5% and 45% of the maternal weight-adjusted dosage, with a median dose of approximately 11%. Infant serum levels of this drug plus metabolite range from 14% to 74% of simultaneous maternal levels (the higher values reflect transplacental passage of the drug). Some authorities believe this drug can be used during breastfeeding with periodic monitoring of infant cardiac and thyroid function, especially if only one dose is administered.

References

  1. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories PROD (2002):
  2. "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  4. Cerner Multum, Inc. "Australian Product Information." O 0
  5. United States National Library of Medicine "Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT" (2013):

Therapeutic Duplication Warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

Switch to: Consumer Interactions

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

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