- Amiodarone IV 150 mg bolus, followed by 1 mg/min for 6 hours, and 0.5 mg/min thereafter
- Amiodarone PO 200-400 mg TID or QID for 7 days, then 200–400 mg daily
Distribution and metabolism
- Major metabolite is desesthyl-amiodarone which is potent antiarrhythmic
- Tissue amiodarone and desethyl-amiodarone concentrations may be much higher than plasma concentrations
Therapeutic drug monitoring
- Can be considered in cases where amiodarone was started without a complete initial load
- Steady is reach in approximately 7-14 days after loading
Therapeutic plasma concentrations
- 0.5-2.0 mcg/mL (can also obtain desethyl-amiodarone level)
- No dose adjustment is required for chronic kidney disease or heart failure
- Zipes, et al. Braunwald’s Heart Disease, A Textbook of Cardiovascular Medicine, 11 th edition, Chapter 36, Therapy of Cardiac Arrhythmias.
- Campbell TJ, Williams KM. Therapeutic drug monitoring: antiarrhythmic drugs. J Clinical Pharmacol. 2001;52:21S-35S.