From the Research
Amiodarone tablets should not be crushed and administered through a nasogastric (NG) tube due to concerns about unpredictable drug delivery and potential underdosing, as well as the risk of local inflammation caused by the medication's irritant properties. The most recent and highest quality study on this topic is from 2007, which found that serum amiodarone concentrations were significantly lower when the drug was administered via a nasogastric tube into the stomach conduit in patients after esophagectomy compared to those concentrations after oral administration in a control population 1. This study suggests that nasogastric administration of amiodarone may not be effective and should probably be avoided.
Some key points to consider when administering amiodarone to patients who cannot take oral medications include:
- The intravenous (IV) formulation of amiodarone is recommended for patients who cannot take oral medications, as it provides more reliable drug delivery and is specifically designed for parenteral administration 1.
- Crushing amiodarone tablets is problematic due to the medication's poor water solubility and potential to adhere to the NG tube, resulting in unpredictable drug delivery and potential underdosing 2.
- Amiodarone has irritant properties that may cause local inflammation when administered in crushed form, which can lead to further complications 3.
- For patients requiring amiodarone via NG tube, consulting with a pharmacist about obtaining a liquid formulation or converting to the IV formulation at an appropriate dosage adjustment may be necessary 1.
Overall, the evidence suggests that crushing amiodarone tablets and administering them through a nasogastric tube is not a recommended practice due to concerns about drug delivery and potential side effects. Instead, alternative formulations and administration methods should be considered to ensure effective and safe treatment.