Cordarone Injection (Amiodarone Hydrochloride)
Compared with: Blackmores Conceive Well Gold 28 Tablets + 28 Capsules

Cordarone Injection (Amiodarone HCl 150 mg/3 mL) is a class III antiarrhythmic for life‑threatening ventricular arrhythmias. A typical regimen delivers a 300 mg IV bolus over 10 minutes, followed by a continuous infusion of 1 mg/min for 6 hours then 0.5 mg/min for 18 hours, achieving rapid suppression of ventricular tachycardia/fibrillation and hemodynamic stabilization
Medscape Reference
Amiodarone Hydrochloride (equivalent to 150 mg amiodarone base per 3 mL ampoule)
Sanofi

Pacerone® Injection (US)

Amiodarone HCl IV

Class III Antiarrhythmic

Cordarone IV Solution

Amiodarone prolongs the myocardial cell‑action potential by blocking potassium channels (phase 3 repolarization), and exerts additional sodium‑ and calcium‑channel blockade, plus noncompetitive α‑ and β‑adrenergic inhibition. This broad electrophysiologic profile suppresses reentrant and automatic arrhythmias in atrial and ventricular tissue

Ventricular Fibrillation & Unstable Ventricular Tachycardia: Refractory to CPR and defibrillation.

Hemodynamically Unstable VT: Acute management in ICU/ER settings.

Rate Control in Atrial Fibrillation/Flutter: Off‑label IV use when rapid control needed.

Peri‑Cardioversion: Adjunct to electrical cardioversion in recurrent VT/VF
Sanofi

Loading and Maintenance
Phase Dose Infusion Rate
Bolus (Acute Arrest) 300 mg IV (6 mL) Undiluted IV push over 10 minutes
Second Bolus (If Needed) 150 mg IV Repeat after ≥5 minutes if VF/VT persists
Loading Infusion 360 mg total 1 mg/min over 6 hours
Maintenance Infusion 540 mg total 0.5 mg/min over next 18 hours

Alternate Regimen (First 24 h): 150 mg IV over 10 min → 1 mg/min × 6 h → 0.5 mg/min × 18 h
Dilution: Infuse in non‑PVC bag with ≥50 mL of 5 % dextrose if prolonged infusion.

Transition to Oral: Begin 200 mg TID oral dosing once stable; taper per protocol
Sanofi

Prescribing Information
Formulation: Sterile solution, 50 mg/mL; supplied as 150 mg/3 mL ampoules.

Route: Intravenous (IV) or intramuscular (IM) injection; IV infusion preferred.

Legal Status: Prescription Only (Rx‑only).

Storage: Store ampoules at 20–25 °C; protect from light; use immediately after opening.

Pregnancy Category D: Use only if maternal benefit outweighs fetal risk; associated with fetal thyroid dysfunction.

Breastfeeding: Minimal excretion in milk; monitor neonatal thyroid and liver function.

Pediatric: Experienced use in children ≥2 years for refractory arrhythmias; dose strictly weight‑based.

Elderly: Increased risk of hypotension and bradycardia; start at lower infusion rates.

Renal/Hepatic Impairment: No formal adjustments; monitor for toxicity given prolonged half‑life.
Common:

Hypotension (up to 10 %)
NCBI

Bradycardia, heart block

Phlebitis at infusion site

Serious:

QT prolongation → torsades de pointes (rare)

Cardiogenic shock, asystole in overdose

Pulmonary toxicity (chronic use)

Thyroid dysfunction (hypo‑ or hyper‑thyroidism)

Cardiac Monitoring Required: Continuous ECG and blood‐pressure monitoring during infusion.

Rebound Arrhythmia: Reduce infusion rate gradually to avoid sudden arrhythmic events.

Drug‑Induced Pulmonary Toxicity: With chronic IV/oral use—close follow‑up for respiratory symptoms.

Thyroid Dysfunction: Baseline thyroid tests; periodic monitoring during prolonged therapy.

Co‑administered Drug Interaction Recommendation
Digoxin ↑Digoxin levels via P‑gp inhibition Reduce digoxin dose; monitor levels
Warfarin ↑INR via CYP2C9/3A4 inhibition Reduce warfarin dose by ~25–40 %; monitor PT/INR
Statins (simvastatin, lovastatin) ↑Risk of myopathy via CYP3A4 inhibition Use lower statin dose; monitor for toxicity
Beta‑Blockers / CCBs (verapamil) Additive bradycardia and AV block Adjust dosages; monitor heart rate/ECG
Class I Antiarrhythmics ↑Arrhythmia risk with disopyramide, flecainide, etc. Avoid combined use
FAQs – Cordarone® Injection (Amiodarone HCl)
Q1. How quickly does IV amiodarone act?
A: Onset within minutes post‑bolus; peak antiarrhythmic effect during first infusion phase (1 mg/min)

Q2. Can infusion be repeated if VT/VF recurs?
A: Yes—repeat 150 mg bolus after ≥5 minutes for refractory episodes; monitor cumulative dose.

Q3. Is a filter required for IV push?
A: No filter needed for direct IV bolus; use non‑PVC bag for infusion.

Q4. What monitoring is essential?
A: Continuous ECG, BP, and respiratory status during and after infusion.

Q5. How to transition to oral therapy?
A: Initiate oral 200 mg TID once hemodynamically stable; overlap IV and oral for a minimum of 24 hours.

Q6. What if hypotension occurs?
A: Slow or pause infusion; administer IV fluids and vasopressors as needed.

Q7. Can Cordarone be used IM?
A: IM route is possible in emergencies but limited by painful injection and variable absorption; IV preferred.

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