Amiodarone
Refractory VF/pulseless VT, Stable wide-complex tachycardia, Rate control in atrial fibrillation
Indications
- Refractory VF/pulseless VT
- Stable wide-complex tachycardia
- Rate control in atrial fibrillation
Adult dosing
- cardiac arrest: dose: 300; unit: mg; route: IV push; interval: then 150mg repeat x1; fixed: true; stable vt: dose: 150; unit: mg; route: IV over 10min; fixed: true; afib: dose: 150; unit: mg; route: IV over 10min, then 1mg/min x6h, then 0.5mg/min x18h; fixed: true
Pediatric dosing
- cardiac arrest: dose: 5; unit: mg/kg; maxDose: 300; maxDoseAbsolute: true; route: IV/IO rapid push; weightBased: true; svt stable vt: dose: 5; unit: mg/kg; maxDose: 300; maxDoseAbsolute: true; route: IV over 20-60 min; weightBased: true
Contraindications
- Cardiogenic shock
- Severe sinus node disease (without pacemaker)
- Second/third degree AV block (without pacemaker)
- Iodine hypersensitivity
Clinical pearls
- Cardiac arrest: 300mg IV/IO push after 3rd shock in refractory VF/VT
- Stable VT: 150mg IV over 10 minutes — avoid rapid push (hypotension)
- Contains iodine — can cause thyroid dysfunction with chronic use
- Half-life 40-55 days — effects persist long after discontinuation
Source and review
- ACLS Guidelines 2020, AHA. Last reviewed: 2024-11-01