Amiodarone tablets

Patient information leaflet

Introduction

• You have been given this leaflet because you are about to start taking a medicine called Amiodarone.
• A Pharmacist, Doctor, or Nurse will go through this leaflet with you and answer any questions you have.
• The aim of this leaflet is to give you important information about Amiodarone, including:
  • What Amiodarone is and what it is used for
  • Tests required before starting treatment
  • On-going monitoring
  • How to take Amiodarone tablets?
  • Possible side-effects
  • If it reacts with other medicines
  • Other warnings
  • Further information.
• This leaflet is for patients, or carers of patients, who have been prescribed Amiodarone.
• Please read the manufacturer's patient information leaflet as well as this leaflet before starting to take your medication.

What is Amiodarone and what is it used for?

• Amiodarone tablets belong to a group of medicines known as antiarrhythmics.
• They are used to treat serious or life-threatening heart rhythm disorders.
• This is when the heart beats too fast or out of rhythm.
• These tablets help restore a normal heart rhythm.
• Amiodarone helps regulate the heartbeat by slowing down the electrical signals that pass through the heart.

Before starting treatment with Amiodarone

Please tell your Doctor or Pharmacist if you:

• Have ever had an allergic reaction to Amiodarone in the past; or allergic to iodine, or any other ingredients in medicines
• Have a history of thyroid problems (a thyroid function test is needed before beginning treatment)
• Are pregnant or planning to become pregnant
• Are breastfeeding
• Have any liver or kidney conditions.

Tests needed before starting treatment

• Amiodarone is usually prescribed to you by a Cardiologist (a heart specialist Doctor).
• It affects the heart but can also affect the lungs, liver, and thyroid gland.
• To make sure that the medication is safe and right for you to take, the Cardiologist will do some tests:

1. An Electrocardiogram (ECG)
2. Liver Function Tests (LFTs)
3. Thyroid Function Tests (TFTs)
4. Blood tests for general biochemistry (electrolytes)

Ongoing monitoring when taking Amiodarone

• You must take the Amiodarone as your Doctor advises.
• You will need a blood test every six months to monitor your liver and thyroid function, and an ECG (what is this) once a year. Your GP will usually arrange these tests.
• Additional tests to be carried out:
  • If lung effects are suspected or seen: a CT scan (Computerised Tamography).
  • If thyroid dysfunction is suspected or seen: a Thyroid Stimulating Hormone (TSH) test.
  • If you have difficulties with your eyes and your vision, such as blurring and/or visual loss: An eye examination.
• Because this medicine can affect your eyes over time, it is a good idea to see an optician once a year, even if you do not have any symptoms.
• When your Doctor decides to stop Amiodarone, you may still need to have blood tests for a few months after you have finished.
• This is because the effects of Amiodarone, as described above, can continue for one year later.

How to take Amiodarone?

• Take your Amiodarone tablets exactly as instructed on the label.
• Usually, a higher dose, known as a loading dose, is prescribed for the first two weeks.
• This is to allow Amiodarone to build up in your body and start working effectively sooner.
• After this, the dose is usually reduced to a maintenance dose, to keep your heart rhythm stable.
• This is often taken once a day.
• Try to take Amiodarone tablets at the same time, each day, with a glass of water.

What should I do if I forgot to take a dose?

• Take it as soon as you remember.
• However, if it is time for the next dose, skip the missed dose and do not take a double dose to make up for the forgotten dose.

How long do I take Amiodarone for?

• Your treatment plan will be reviewed regularly by your Doctor.
• Do not stop taking Amiodarone without discussing it with your Doctor first.

Possible side effects to be aware of:

• Like all medicines, Amiodarone can cause side effects, although not everyone will experience them.
• Some side effects may be serious and can happen at any time during treatment.

1. Allergic reactions

• This doesn't happen often. But if you get a rash, have trouble breathing or swallowing, or if your face, lips, eyes, throat, or tongue start to swell, it could be an allergic reaction.
• Stop taking Amiodarone right away and get help from a Doctor as soon as possible.

2. Adverse reactions in the lungs

• If you experience any of the below you must tell your Doctor or get medical help right away:
  • start to feel short of breath
  • have trouble breathing (especially if it gets worse over time)
  • feel tightness in your chest
  • have a cough that won't go away
  • hear wheezing when you breathe
  • lose weight without trying
  • get a fever
• These could be signs of swelling in your lungs. It can be serious, but it can be treated if you catch it early.

3. Adverse effects on thyroid function

• Amiodarone can change your thyroid hormone levels, making them go too high or too low.
• Symptoms of thyroid issues may include:
  • weight changes
  • intolerance to heat or cold
  • hair thinning, sweating, menstrual changes,
  • swelling in the neck (goitre)
  • nervousness, irritability, restlessness, or difficulty concentrating.

4. Adverse effects on the heart

• Amiodarone may slow your heart rate, causing:
  • tiredness
  • dizziness, or fainting.
• If your heartbeat starts to feel strange or uneven, your Doctor will need to check your medicine and see if any changes are needed.

5. Adverse effects on the liver

• Amiodarone can affect how you liver works. Symptoms of liver problems include:
  • yellowing of the skin or eyes (jaundice)
  • loss of appetite,
  • stomach pain, or fever (high temperature)
• These can be serious, and you must contact your GP.

6. Adverse effects on the eyes

• Amiodarone can cause blurred vision or coloured 'halos' around lights.
• These are usually mild and you do not need to stop treatment.
• If you experience blurred or reduced vision, it may be because of eye damage. A yearly eye check by an Optician is important when you are taking Amiodarone.

7. Adverse effects on the skin

• Amiodarone can make your skin more sensitive to sunlight.
• Avoid direct sun exposure and sunlamps.
• Wear protective clothing and apply high-factor sunscreen to exposed skin.
• Some people may also develop a grey or blue colour to their skin. This may fade after stopping the medication, but in some cases, it may not completely disappear.

8. Adverse effects on the nervous system

• Amiodarone can cause symptoms such as trembling, unsteady walking, weakness in the hands or legs, or pins and needles.
• If you experience any of these, immediately contact your GP or seek medical advice.
• This helps you get to the Cardiology team quickly.
• They will check if you should keep taking Amiodarone or stop it, and they can also send you to other experts if you need help with any side effects.

Interactions with other medicines

• Before starting any new medications, supplements, or herbal remedies, please consult your Doctor or Pharmacist to check for possible reactions with Amiodarone.

Lifestyle advice

• Food and drink: Avoid drinking grapefruit juice, as it can increase the risk of side effects.

• Alcohol: Limit your alcohol intake, as alcohol can raise the likelihood of liver problems while on Amiodarone.

• Driving: Amiodarone may cause blurred vision and sensitivity to bright lights, particularly at night. If you experience these effects, you should avoid driving or operating machinery.

Further information

• If you have further questions, please contact your GP or local community Pharmacist.

Get more information about Amiodarone

• British Heart Foundation (BHF) - What are the side effects of amiodarone? https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/ask-the-experts/amiodarone
• Arrhythmias (abnormal heart rhythms) https://www.bhf.org.uk/informationsupport/conditions/arrhythmias
• Arrhythmia Alliance: https://heartrhythmalliance.org/aa/uk/

Contact our service

You can contact our Medicines Information on 020 7288 5758.