Amiodarone Hydrochloride Capsules

This product belongs to Class III antiarrhythmic drugs. The main electrophysiological effect is to prolong the action potential and effective refractory period of various myocardial tissues, which is conducive to eliminating reentrant excitation. At the same time, it has mild non-competitive α and β adrenergic receptor blocking and mild Class I and IV antiarrhythmic properties. Reduce the automaticity of the sinus node. It has no effect on the resting membrane potential and action potential height. The inhibition of forward conduction of the atrioventricular bypass pathway is greater than the reverse. Due to excessive prolongation of repolarization, the electrocardiogram has QT interval prolongation and T wave changes after oral administration, which can slow down the heart rate by 15~20% and prolong the PR and Q-T intervals by about 10%. It has a direct dilation effect on the coronary arteries and peripheral blood vessels. It can affect thyroid hormone metabolism. The characteristics of this product are long half-life, so the number of medications is small, the therapeutic index is large, and the antiarrhythmic spectrum is wide.

The chemical name of this product is: (2-butyl-3-benzofuranyl) [4-[2-(diethylamino)ethoxy]-3,5-diiodophenyl]methanone hydrochloride

This product is a capsule, and the contents are off-white powder.

Oral administration is suitable for the prevention of life-threatening paroxysmal ventricular tachycardia and ventricular fibrillation. It can also be used for paroxysmal supraventricular tachycardia, paroxysmal atrial flutter, and atrial fibrillation that are ineffective with other drugs, including those with preexcitation syndrome and maintenance treatment after electrical cardioversion of persistent atrial fibrillation and atrial flutter. It can be used to control the ventricular rate during persistent atrial fibrillation and atrial flutter. It is generally not suitable for the treatment of atrial and ventricular premature beats unless there are clear indications.

Common oral dosage for adults: For the treatment of supraventricular arrhythmias, take 0.4-0.6g per day, divided into 2-3 times. After 1-2 weeks, change to 0.2-0.4g per day as needed. Some patients can reduce the dose to 0.2g, 5 days a week or a smaller dose for maintenance. For the treatment of severe ventricular arrhythmias, take 0.6-1.2g per day, divided into 3 times. After 1-2 weeks, gradually change to 0.2-0.4g per day as needed.

1. Cardiovascular: Compared with other antiarrhythmic drugs, it has fewer adverse cardiovascular reactions. ① Sinus bradycardia, sinus arrest or sinoatrial block, atropine cannot counteract this reaction; ② Atrioventricular conduction block; ③ Occasionally, Q-T interval prolongation with torsades de pointes; mainly seen in hypokalemia and when other drugs that prolong QT are used in combination; the above adverse reactions are mainly seen in long-term high doses and when accompanied by hypokalemia. In all the above situations, the drug should be discontinued. It can be treated with pressor drugs, isoproterenol, sodium bicarbonate (or sodium lactate) or pacemaker; pay attention to correcting electrolyte disorders; direct current cardioversion can be used when torsades de pointes develops into ventricular fibrillation. Due to the long half-life of this product, the treatment of adverse reactions needs to last for 5 to 10 days. 2. Thyroid: ① Hyperthyroidism, which can occur during or after medication. In addition to exophthalmos, typical signs of hyperthyroidism may appear, and new arrhythmias may also occur. Laboratory tests show that T3 and T4 are both increased and TSH is decreased. The incidence rate is about 2%. It can completely disappear after stopping the drug for several weeks to several months. A few people need to be treated with antithyroid drugs, propranolol or adrenocortical hormones; ② Hypothyroidism, the incidence rate is 1% to 4%, which is more common in the elderly. Typical signs of hypothyroidism may appear, and the TSH test is elevated. It can disappear after stopping the drug for several months, but myxedema may remain. If necessary, thyroxine can be used for treatment. 3. Gastrointestinal tract: constipation, a few people have nausea, vomiting, and decreased appetite, which is obvious when the load is high. 4. Eyes: Those who have taken the drug for more than 3 months have yellow-brown pigmentation in the lower 1/3 of the corneal basal layer, which is related to the course of treatment and dosage, and rarely occurs in children. This deposit may occasionally affect vision, but there is no permanent damage. A few people may have halos, and rarely stop taking the drug due to eye side effects. 5. Nervous system: rare, related to the dose and course of treatment, tremor, ataxia, proximal muscle weakness, extrapyramidal signs may occur, patients who have taken the drug for more than 1 year may have peripheral neuropathy, which gradually subsides after reducing or stopping the drug. 6. Skin: photosensitivity is related to the course of treatment and dose, slate blue pigmentation of the skin, which gradually subsides after a long time (1 to 2 years) after stopping the drug. Other allergic rashes subside quickly after stopping the drug. 7. Liver: hepatitis or fatty infiltration, increased aminotransferase, related to the course of treatment and dose. 8. Lungs: Lung adverse reactions often occur in patients who take large amounts of drugs for a long time (0.8 to 1.2g a day). Mainly allergic pneumonia, leading to fibrosing alveolitis. Onset of the disease: Foamy macrophages and type 2 pneumocytes proliferate in the alveoli and interstitium, and there is fibrosis, and occlusion of small bronchial cavities. Clinical manifestations include chest tightness, shortness of breath, dry cough and chest pain, etc., which can be fatal in severe cases. Laboratory tests can show. Restrictive pulmonary ventilation dysfunction, increased erythrocyte sedimentation rate and increased white blood cell count. If the above symptoms occur in the lungs, stop taking the drug and treat with adrenocortical hormones. 9. Others: Hypocalcemia and increased serum creatinine may occur occasionally.

1. It is contraindicated for patients with severe sinus node dysfunction; 2. It is contraindicated for patients with II or III degree atrioventricular block; 3. It is contraindicated for patients with syncope caused by bradycardia; 4. It is contraindicated for patients who are allergic to this product.

Precautions for children: The safety and effectiveness of amiodarone in children are still unclear. Precautions for pregnancy and lactation: This product can enter the fetus through the placenta. Clinically, there are reports that pregnant women taking amiodarone can cause congenital goiter, hyperthyroidism and hypothyroidism in the fetus. The concentration of the original drug and metabolites in the blood of newborns is 25% of the maternal blood concentration. It is known that iodine can also pass through the placenta, so pregnant women should weigh the pros and cons when using it. This product and its metabolites can be secreted in breast milk, so those who take this product should not breastfeed. Precautions for the elderly: Elderly people who take amiodarone orally need to closely monitor their electrocardiogram and lung function.

1. Increase the anticoagulant effect of warfarin, which can last from 4 to 6 days after the addition of this product to several weeks or months after discontinuation of the drug. When used in combination, the prothrombin time should be closely monitored and the dose of the anticoagulant should be adjusted. 2. Enhance the effects of other antiarrhythmic drugs on the heart. This product can increase the concentrations of quinidine, procainamide, flecainide and phenytoin in plasma. Combination with Class Ia drugs can aggravate the prolongation of the Q-T interval and, in rare cases, can cause torsades de pointes, so special caution should be used. From the start of the addition of this product, the original antiarrhythmic drug should be reduced by 30% to 50% in dose and gradually discontinued. If it must be used in combination, it is usually recommended to reduce the dose by half. 3. Combination with beta-blockers or calcium channel blockers can aggravate sinus bradycardia and sinus arrest

Keep in a light-proof and airtight container.

0.2g

24 months

Chongqing KERUI Pharmaceutical (GROUP) Co., Ltd.

• Founded in:

  1999-03-03

• Address:

  No. 2 Dashizhi Road, Nan'an Economic and Technological Development Zone, Chongqing

• Tax NO.:

  915001082031636780

• Registered Funds:

  110.6375 million yuan

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