Cordarone (Amiodarone) – Potent Antiarrhythmic Medication

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What is Cordarone used for
Cordarone (amiodarone) is a prescription antiarrhythmic medication used to treat and prevent life-threatening ventricular arrhythmias such as ventricular tachycardia and ventricular fibrillation. It normalizes abnormal heart rhythms by blocking potassium, sodium, and calcium channels to stabilize electrical conduction.

Brand Name: Cordarone®, Pacerone®

Generic Name: Amiodarone Hydrochloride

Drug Class: Class III Antiarrhythmic (with multi-channel blockade)

Formulation: Oral tablet, 200 mg

Prescription Status: Rx only

Manufacturer: Wyeth Pharmaceuticals (brand), multiple generics

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Amiodarone HCl – available as Cordarone® and Pacerone®

Also referred to simply as amiodarone tablets

Amiodarone exerts its antiarrhythmic effect through:

Class III activity: Inhibition of potassium channels, prolonging cardiac repolarization and refractory period

Class I, II, and IV actions: Weak blockage of sodium and calcium channels and noncompetitive adrenergic receptor blockade

Combined, these effects stabilize cardiac conduction and suppress life-threatening arrhythmias
NCBI

Cordarone is indicated for:

Treatment of life-threatening recurrent ventricular fibrillation and hemodynamically unstable ventricular tachycardia, especially when other therapies fail
FDA Access Data

Off-label use in atrial fibrillation and supraventricular tachycardia under specialist care

Adult Oral Regimen:
Loading Phase: 800–1,600 mg daily (divided doses) for 1–3 weeks until rhythm control achieved

Short-Term Maintenance: 600–800 mg/day for approx. 1 month

Long-Term Maintenance: Typically 400 mg/day
FDA Access Data

Administer consistently with regard to meals

Adjust regimen based on arrhythmia control and emergence of adverse effects

Prescribing & Safety Information
Initiation: Typically inpatient; monitor ECG, liver enzymes, thyroid function, chest X-ray, pulmonary function, and electrolytes (potassium, magnesium, calcium)
Healthline

Contraindications:

Severe sinus node dysfunction or AV block without pacemaker

Bradycardia-induced syncope

Cardiogenic shock

Known allergy to amiodarone or iodine

Severe hepatic impairment

Safety Monitoring
Cordarone has a unique pharmacokinetic profile with a long half-life (~25–100 days), leading to tissue accumulation and delayed adverse effects
Verywell Health

Pulmonary: Risk of interstitial pneumonitis / fibrosis – chest X-ray and PFTs before and periodically
WebMD

Thyroid: Might cause hypo- or hyperthyroidism due to iodine content – monitor TSH, T3, T4
RxList

Hepatic: Can induce hepatotoxicity – check ALT/AST, discontinue if ≥3× normal or signs of liver injury
RxList

Cardiac: Monitor ECG for bradycardia, heart block, QT prolongation; watch for Torsades de Pointe
NCBI

Ophthalmic: Corneal deposits in >90% after 6 months; eye exams advised

Dermatologic: Photosensitivity and bluish-gray skin discoloration with sun exposure
Healthline

System Effect
CNS Tremor, headache, ataxia, peripheral neuropathy
FDA Access Data

Gastrointestinal Nausea, anorexia, constipation
Healthline

Cardiac Bradycardia, heart block, new arrhythmias
RxList

Cutaneous Photosensitivity, blue-gray skin pigmentation
Healthline

Ocular Corneal microdeposits, halos


Serious Adverse Reactions & Warnings
Pulmonary Toxicity: May be fatal; discontinue if respiratory symptoms emerge
WebMD

Thyroid Dysfunction: Occurs in ~15–20%; manage with endocrine therapy

Hepatotoxicity: Severe risk; requires treatment interruption in significant enzyme elevation

Ocular Toxicity: Risk of optic neuropathy; regular eye assessments needed

Amiodarone profoundly interacts via CYP450 inhibition and pharmacodynamic effects:

Warfarin: Raises INR – dose may need 30–40% reduction and frequent monitoring

Digoxin: Increases plasma levels – monitor for toxicity
MedlinePlus

Statins (e.g., simvastatin): Heightened risk of myopathy/rhabdomyolysis

Beta-blockers & Calcium channel blockers: Additive bradycardia/heart block risk

Other QT-prolonging agents: Elevated Torsades risk – avoid combining with cisapride, dofetilide, etc.
Cleveland Clinic

Grapefruit juice: Reduces metabolism, increases levels and toxicity
Healthline

Other interactions: Including rifampin, antiarrhythmics, antifungals, HIV protease inhibitors
MedlinePlus

Drug Classification
ATC Code: C01BD01

Therapeutic Class: Class III Antiarrhythmic

Prescription Status: Rx only

Controlled Substance: No

Frequently Asked Questions (Q&A)
Q1. What is Cordarone used for?
Cordarone treats and prevents life-threatening ventricular arrhythmias like VT and VF when other drugs fail
Verywell Health
FDA Access Data

Q2. How long does it take to work, and how long does it stay in the body?
Initial effect occurs during 1–3-week loading phase. Its half-life ranges from 25–100 days—tissue levels remain for months after discontinuation
Verywell Health
Q3. Is Cordarone suitable for long-term use?
Yes—when benefits outweigh risks—but long-term use requires strict monitoring for lung, thyroid, liver, and eye toxicity.

Q4. Can you drink grapefruit juice while on Cordarone?
No. It inhibits metabolism and raises blood levels, increasing adverse effect risk
Healthline

Q5. What precautions are necessary?
Baseline and periodic monitoring (ECG, liver, thyroid, lung), avoid sun exposure, use contraception during and months after treatment, and avoid combination with interacting drugs.

Q6. Can women who are pregnant or nursing take Cordarone?
No—pregnancy is contraindicated; breastfeeding is also prohibited due to infant exposure risk

Store at 20–25 °C, protected from light

Keep in original container

Keep out of reach of children

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