amiodarone hydrochloride and lithium: what the product label says

The product label for amiodarone hydrochloride names lithium in its drug-interaction information. The complete selected section is reproduced below so that qualifications stay with the finding.

Which products this evidence covers

Amiodarone Hydrochloride — TABLET — ORAL

Labeled active ingredients: AMIODARONE HYDROCHLORIDE; AMIODARONE. Routes: ORAL. Dosage forms: TABLET.

Supporting label passage

Section: 7 DRUG INTERACTIONS

Because of amiodarone’s long half-life, expect drug interactions to persist for weeks to months after discontinuation of amiodarone. Drug interactions with amiodarone are described in Table 1 below. Table 1: Amiodarone Drug Interactions Concomitant Drug Class/Name Examples Clinical Comment Pharmacodynamic Interactions QT Prolonging Drugs class I and III antiarrhythmics,lithium, certain phenothiazines,tricyclicantidepressants,certainfluoroquinoloneandmacrolideantibiotics, azole antifungals,halogenatedinhalationanestheticagents Increasedrisk of Torsade de Pointes.Avoidconcomitantuse. Negative Chronotropes digoxin, beta blockers,verapamil,diltiazem,clonidine,ivabradine Potentiatestheelectrophysiologicandhemodynamiceffects of amiodarone, resultinginbradycardia, sinusarrest,andAVblock. Monitor heartrate. Pharmacokinetic Interactions CYP450 Inhibitors grapefruitjuice,certainfluoroquinoloneandmacrolideantibiotics, azole antifungals,cimetidine,certain protease inhibitors Increasedexposure of amiodarone. Avoidconcomitant use. CYP450 Inducers St.John’sWort Reducedamiodarone serum levels. Cyclosporine Increasedplasmalevelsofcyclosporinehave been reported resultinginelevatedcreatinine,despitereduction of cyclosporinedose. Monitorcyclosporinedruglevelsand renal functionwithconcomitant use. Cholestyramine Reducedamiodarone serum levels. Antiarrhythmics quinidine,procainamide,flecainide Reserveconcomitantuseforpatientswho are unresponsiveto a singleagent.Antiarrhythmicmetabolisminhibitedbyamiodarone.Initiateantiarrhythmic at a lowerthanusual dose and monitorpatientcarefully. Reduce dose levels of previouslyadministeredantiarrhythmic by 30 to 50% forseveraldaysaftertransitioningto oral amiodarone.Evaluatecontinuedneedforantiarrhythmic. Digoxin Increaseddigoxinconcentration.Reducedigoxinby half or discontinue. If continued,monitorforevidenceoftoxicity. HMG-CoA ReductaseInhibitors simvastatin,lovastatin,atorvastatin Increasedplasma concentration of HMG-CoA reductaseinhibitor. Limitthe dose of lovastatinto 40 mg.Limit the coadministered dose of simvastatinto 20 mg. Lowerstarting dose of other CYP3A4substratesmay be required. Warfarin Potentiatesanticoagulant response and can resultinserious or fatalbleeding.Coadministrationincreasesprothrombintimeby 100% after 3 to 4 days.Reducewarfarin dose byone-thirdtoone-halfandmonitorprothrombin times. Phenytoin Increasedsteady-state levels of phenytoin.Monitorphenytoin levels. Hepatitis C DirectActingAntiviral sofosbuvir Casesofsymptomaticbradyarrhythmiarequiringpacemaker insertion have been reported inpatientson oral maintenanceamiodaronewhoinitiatedtherapywithsofosbuvir. CYP3A Substrate lidocaine Sinus bradycardia has been reported with oral amiodarone in combination with lidocaine given for local anesthesia. Monitor heart rate. A lower starting dose of lidocaine may be required. CYP3A Substrate fentanyl Fentanyl in combination with amiodarone may cause hypotension, bradycardia, and decreased cardiac output.

Read the full product label on DailyMed. Label version 10, dated 2026-02-12.

Limits of this evidence

This passage applies to the labeled product and circumstances it describes. It must not be generalized to other routes or formulations. It does not independently validate CDI’s severity category, establish safety for an individual, or replace the full label. The stored interaction description and classification have not been changed by this article.

How this brief was prepared

Automatic checks matched drug identities, retrieved and preserved the label, and checked the full quoted section with AI assistance on 2026-11-03. The public explanation uses a fixed template; model-written medical advice is not published. Independent clinical review has not been recorded.

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