From the Guidelines
The dosage for Amiodarone infusion is 150 mg given over 10 minutes, followed by a maintenance infusion of 1 mg/min for 6 hours, and then 0.5 mg/min. The total dose over 24 hours should not exceed 2.2 g.
Key Points
- The initial dose of Amiodarone is administered as a rapid infusion of 150 mg over 10 minutes 1, 2, 3.
- This is followed by an early maintenance infusion of 1 mg/min for 6 hours 1, 2, 3.
- The maintenance infusion is then reduced to 0.5 mg/min 1, 2.
- The total dose of Amiodarone should not exceed 2.2 g over 24 hours 1.
- Amiodarone can cause adverse effects such as hypotension, bradycardia, and phlebitis 1, 2, 3.
Administration Considerations
- Amiodarone should be administered with caution in patients with heart failure and accessory pathway 4.
- The dosage of Amiodarone may need to be adjusted based on the patient's response and the presence of any adverse effects 2.
From the FDA Drug Label
The recommended starting dose of amiodarone is about 1000 mg over the first 24 hours of therapy, delivered by the following infusion regimen: After the first 24 hours, continue the maintenance infusion rate of 0.5 mg/min (720 mg per 24 hours) Do not exceed an initial infusion rate of 30 mg/min.
The dosage for Amiodarone infusion is:
- Initial dose: 1000 mg over the first 24 hours
- Maintenance dose: 0.5 mg/min (720 mg per 24 hours)
- Maximum initial infusion rate: 30 mg/min 5
From the Research
Amiodarone Infusion Dosage
The dosage for Amiodarone infusion can vary depending on the specific condition being treated.
- For pharmacological cardioversion of recent-onset atrial fibrillation, intravenous amiodarone has been used as a bolus only or as a bolus followed by a continuous i.v. infusion until conversion or up to 24 h, with a dose of i.v. bolus ranging from 3 to 7 mg/kg body weight and that of infusion from 900 to 3000 mg/day 6.
- A study found that the highest 24-h conversion rates have been reported with the i.v. regimen of 125 mg/h until conversion or a maximum of 3 g 6.
- Another study used an intravenous amiodarone dose of 5 mg/kg as a 30 min intravenous (i.v.) infusion, followed by i.v. infusion of 10 mg/kg during 20 h, with a mean dose of amiodarone administered until sinus rhythm restoration of 740 +/- 296 mg 7.
- The dose of amiodarone for infusion can also be based on the patient's weight, with a dose of 5 mg/kg as a 30 min intravenous (i.v.) infusion, followed by i.v. infusion of 10 mg/kg during 20 h 7.
Key Considerations
- The efficacy of amiodarone for pharmacological cardioversion of recent-onset atrial fibrillation is dose-dependent, with higher doses (>1500 mg/day) being more effective than lower doses 6.
- Amiodarone can be used in patients with structural heart disease and in those with left ventricular systolic dysfunction, but the dose should be adjusted accordingly 6, 8.
- The side effects of amiodarone can be decreased significantly by keeping the maintenance dose at 200 to 300 mg/day 8.
- Low-dose amiodarone, defined as 200 mg/day or less, has been found to be safe with a low incidence of side effects requiring medication discontinuation 9.