Amiodarone Hydrochloride

Increased risk of Torsades de Pointes and increased amiodarone exposure. Avoid concomitant use.

CYP450 inhibitor that increases amiodarone exposure. Avoid concomitant use.

Increased risk of Torsade de Pointes. Avoid concomitant use.

CYP450 inhibitor that increases amiodarone exposure. Avoid concomitant use.

Increased risk of Torsade de Pointes. Avoid concomitant use.

Increased risk of Torsade de Pointes. Avoid concomitant use.

Increased risk of Torsade de Pointes. Avoid concomitant use.

Increased risk of Torsade de Pointes. Avoid concomitant use.

Increased exposure of amiodarone via CYP450 inhibition. Avoid concomitant use.

Increased risk of Torsade de Pointes. Avoid concomitant use.

Potentiates anticoagulant response resulting in serious or fatal bleeding. Increases prothrombin time by 100%. Reduce warfarin dose by one-third to one-half.

Azole antifungals prolong QT interval and inhibit CYP3A/CYP2C8, increasing risk of Torsades de Pointes and amiodarone exposure.

Increases plasma concentration of HMG-CoA reductase inhibitor.

Reduces amiodarone serum levels.

Negative chronotrope. Potentiates electrophysiologic and hemodynamic effects resulting in bradycardia, sinus arrest, and AV block.

Increases plasma levels of cyclosporine resulting in elevated creatinine. Monitor cyclosporine drug levels and renal function.

Potentiates electrophysiologic and hemodynamic effects resulting in bradycardia, sinus arrest, and AV block. Also increases digoxin concentration.

Negative chronotrope. Potentiates electrophysiologic and hemodynamic effects resulting in bradycardia, sinus arrest, and AV block.

May cause hypotension, bradycardia, and decreased cardiac output when combined with amiodarone.

Class I antiarrhythmic. Amiodarone inhibits flecainide metabolism. Reserve concomitant use; initiate at lower dose and reduce previous dose by 30-50%.

Negative chronotrope. Potentiates electrophysiologic and hemodynamic effects resulting in bradycardia, sinus arrest, and AV block.

7.3 Serious Symptomatic Bradycardia When Co-administered with Ledipasvir/Sofosbuvir or with Sofosbuvir with Simeprevir Postmarketing cases of symptomatic bradycardia, some requiring pacemaker insertion and at least one fatal, have been reported when ledipasvir/sofosbuvir or sofosbuvir with simeprevir were initiated in patients on amiodarone.

Non-sedating antihistamine metabolized by CYP3A. QT interval prolongation and torsades de pointes reported with coadministration.

Increases plasma concentration of HMG-CoA reductase inhibitor. Limit dose to 40 mg.

Negative chronotrope. Potentiates electrophysiologic and hemodynamic effects resulting in bradycardia, sinus arrest, and AV block.

Increased steady-state levels of phenytoin requiring monitoring.

Class I antiarrhythmic. Amiodarone inhibits procainamide metabolism. Reserve concomitant use; initiate at lower dose and reduce previous dose by 30-50%.

Antihypertensives: Use amiodarone with caution in patients receiving ß-receptor blocking agents (e.g., propranolol, a CYP3A inhibitor) or calcium channel antagonists (e.g., verapamil, a CYP3A substrate, and diltiazem, a CYP3A inhibitor) because of the possible potentiation of bradycardia, sinus arrest, and AV block; if necessary, amiodarone can continue to be used after insertion of a pacemaker in patients with severe bradycardia or sinus arrest. Hemodynamic and electrophysiologic interactions have also been observed after concomitant administration with propranolol, diltiazem, and verapamil.

Class I antiarrhythmic. Amiodarone inhibits quinidine metabolism. Reserve concomitant use; initiate at lower than usual dose and reduce previous dose by 30-50%.

7.3 Serious Symptomatic Bradycardia When Co-administered with Ledipasvir/Sofosbuvir or with Sofosbuvir with Simeprevir Postmarketing cases of symptomatic bradycardia, some requiring pacemaker insertion and at least one fatal, have been reported when ledipasvir/sofosbuvir or sofosbuvir with simeprevir were initiated in patients on amiodarone.

Increases plasma concentration of HMG-CoA reductase inhibitor. Limit dose to 20 mg.

7.3 Serious Symptomatic Bradycardia When Co-administered with Ledipasvir/Sofosbuvir or with Sofosbuvir with Simeprevir Postmarketing cases of symptomatic bradycardia, some requiring pacemaker insertion and at least one fatal, have been reported when ledipasvir/sofosbuvir or sofosbuvir with simeprevir were initiated in patients on amiodarone.

CYP450 inducer that reduces amiodarone serum levels.

Antidepressant metabolized by CYP3A. QT interval prolongation and torsades de pointes reported with coadministration.

Negative chronotrope. Potentiates electrophysiologic and hemodynamic effects resulting in bradycardia, sinus arrest, and AV block.

Protease inhibitor that inhibits CYP3A, increasing amiodarone serum concentrations. Case report showed increase from 0.9 to 1.3 mg/L with monitoring recommended.

CYP3A substrate. Sinus bradycardia reported with oral amiodarone and lidocaine for local anesthesia. Monitor heart rate; lower starting dose may be required.

Amiodarone can inhibit the metabolism of macrolide/ketolide antibiotics (except for azithromycin) and systemic azole antifungal drugs.

Cyclophosphamide is a prodrug , metabolized by CYP450 including CYP3A to an active metabolite. The metabolism of cyclophosphamide may be inhibited by amiodarone.

Antiarrhythmics: Other antiarrhythmic drugs, such as quinidine, procainamide, disopyramide, and phenytoin, have been used concurrently with amiodarone. Disopyramide causes QT prolongation which could induce arrhythmia.