Drug interactions
Amiodarone + Cardiac Disease
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Overview
In patients with specific cardiac diseases (severe sinus-node dysfunction, 2nd/3rd-degree AV block, marked bradycardia without a pacemaker, or cardiogenic shock), amiodarone can cause profound bradycardia/heart block and is contraindicated; it also prolongs QTc.
Mechanism of action
Pharmacodynamic: amiodarone depresses SA/AV nodal conduction and prolongs repolarization (QTc), increasing risk of bradyarrhythmia and conduction block in susceptible cardiac conditions.
Clinical management
Screen for contraindicated cardiac conditions before initiation. Avoid use or ensure appropriate pacing support if significant conduction disease is present; obtain baseline ECG, monitor heart rate and QTc, and correct electrolytes. Prefer oral over rapid IV administration to minimize hypotension.
Drug reference
References
- Amiodarone hydrochloride (Cordarone/Pacerone) Prescribing Information — FDA Label
- Amiodarone: Drug Information — Lexicomp
Frequently asked questions
Can I take Amiodarone with Cardiac Disease?
The interaction is rated: Major. In patients with specific cardiac diseases (severe sinus-node dysfunction, 2nd/3rd-degree AV block, marked bradycardia without a pacemaker, or cardiogenic shock), amiodarone can cause profound bradycardia/heart block and is contraindicated; it also prolongs QTc.
How serious is the interaction between Amiodarone and Cardiac Disease?
The interaction is rated: Major. Evidence level: High.
How is the interaction between Amiodarone and Cardiac Disease managed?
Screen for contraindicated cardiac conditions before initiation. Avoid use or ensure appropriate pacing support if significant conduction disease is present; obtain baseline ECG, monitor heart rate and QTc, and correct electrolytes. Prefer oral over rapid IV administration to minimize hypotension.
Why do Amiodarone and Cardiac Disease interact?
Pharmacodynamic: amiodarone depresses SA/AV nodal conduction and prolongs repolarization (QTc), increasing risk of bradyarrhythmia and conduction block in susceptible cardiac conditions.
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