As a result, it can affect thyroid function in several different ways: Amiodarone can cause hyperthyroidism . Consider therapy modification, Herbs (Hypotensive Properties): May enhance the hypotensive effect of Blood Pressure Lowering Agents. Avoid cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus. Though classified as a class III antiarrhythmic, it affects all phases of the cardiac action potential. Drugs with QT prolongation potential: Particular caution must be used when a drug with QTc-prolonging potential relies on metabolism via enzymes amiodarone inhibits, since the effect of elevated concentrations may be additive with the effect of amiodarone. The Food and Drug Administration (FDA) defines drug shortages as products used to prevent or treat a serious or life-threatening disease or medical condition for which Dermatologic toxicity: May cause life-threatening or fatal cutaneous reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis (TEN). Consider therapy modification, Cobicistat: May increase the serum concentration of Amiodarone. Avoid combination, Alfuzosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider alternatives to this combination. Patients with additional risk factors for QTc prolongation may be at even higher risk. Monitor therapy, Ranolazine: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Ranolazine. Monitor therapy, Benperidol: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Discard any unused portions of premixed solutions. Consult individual institutional policies and procedures. Consider therapy modification, Siponimod: Bradycardia-Causing Agents may enhance the bradycardic effect of Siponimod. Management: Consider alternatives to this combination. See full monograph for details. This product is available in the following dosage forms: Tablet Crush five 200 mg tablets in a mortar and reduce to a fine powder. Electrical storm and incessant ventricular tachycardia, hemodynamically stableyes. Exceptions: Erythromycin (Systemic); Nilotinib; Ribociclib. >2-week IV infusion: 200 to 400 mg once daily (depending on indication) (Giardina 2019). Oral: Note: Long-term oral maintenance therapy with amiodarone may be considered if other rate control options are ineffective or contraindicated. If combined, monitor for QTc interval prolongation and ventricular arrhythmias. Avoid combination, Lidocaine (Systemic): Amiodarone may increase the serum concentration of Lidocaine (Systemic). Breastmilk and infant serum levels of amiodarone and its active metabolite are somewhat unpredictable, but can be high during breastfeeding. Monitor therapy, RisperiDONE: QT-prolonging Agents (Highest Risk) may enhance the CNS depressant effect of RisperiDONE. Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Avoid combination, Fosamprenavir: May increase the serum concentration of Amiodarone. Patients with additional risk factors for QTc prolongation may be at even higher risk. Management: Canadian labeling recommends avoiding this combination. Fresenius Kabi did not provide a reason for the shortage. Avoid combination, NiMODipine: CYP3A4 Inhibitors (Weak) may increase the serum concentration of NiMODipine. Avoid combination, Darunavir: May increase the serum concentration of Amiodarone. Consider therapy modification, QUEtiapine: QT-prolonging Agents (Highest Risk) may enhance the QTc-prolonging effect of QUEtiapine. Monitor therapy, Ceritinib: Amiodarone may enhance the bradycardic effect of Ceritinib. Avoid combination, Calcium Channel Blockers (Nondihydropyridine): May enhance the bradycardic effect of Amiodarone. Consider therapy modification, DOXOrubicin (Conventional): P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of DOXOrubicin (Conventional). Management: Consider alternatives to this combination. Monitor therapy, Naloxegol: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Naloxegol. Depression in men Why do some men go bald and others don't? Consider therapy modification, Blood Pressure Lowering Agents: May enhance the hypotensive effect of Hypotension-Associated Agents. Photosensitivity: Avoid excessive exposure to sunlight; may cause photosensitivity. A variety of regimens have been used in clinical trials, including oral and IV regimens: Preoperative regimen: 150 mg once, followed by 0.4 mg/kg/hour (~0.5 mg/minute for a 70 kg patient) for 3 days prior to surgery and for 5 days postoperatively (Lee 2000). Oral: 400 mg twice daily for 2 weeks, followed by 400 mg once daily for 4 weeks, then 200 mg once daily in combination with a beta-blocker (Connolly 2006) or some experts recommend 400 mg every 8 to 24 hours for a total oral load of ~6 to 10 g, then 200 to 400 mg once daily (Giardina 2019). Administer through an IV line located as centrally as possible. Nahata MC, Morosco RS, Hipple TF. Management: Colchicine is contraindicated in patients with impaired renal or hepatic function who are also receiving a p-glycoprotein inhibitor. If combined, monitor for QTc interval prolongation and ventricular arrhythmias. Patients with additional risk factors for QTc prolongation may be at even higher risk. Certified Pharmacy Executive Leader (CPEL), Amiodarone injection, Fresenius Kabi, 50 mg/mL, 3 mL vial, 10 count, NDC 63323-0616-03, Amiodarone injection, Fresenius Kabi, 50 mg/mL, 9 mL vial, 10 count, NDC 63323-0616-09, Amiodarone injection, Hikma, 50 mg/mL, 3 mL vial, 25 count, NDC 00143-9875-25. Last updated February 8, 2020. Monitor therapy, Nicorandil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Vhody smoothies zvisia od toho, o do nich dte. Amiodarone can cause hepatotoxicity, which can be fatal. Overview of the clinical utility of ultrasonography in thyroid disease. Outline the indications for amiodarone use. Based on the 2014 AHA/ACC/HRS guideline for the management of patients with AF, the use of amiodarone for pharmacologic conversion of AF to and maintenance of normal sinus rhythm is effective and recommended for this condition. Aripiprazole dose adjustments may or may not be required based on concomitant therapy and/or indication. Assess thyroid function tests before initiation of treatment and then periodically thereafter (some experts suggest every 3 to 6 months). Avoid combination, Indinavir: May increase the serum concentration of Amiodarone. Colchicine distribution into certain tissues (e.g., brain) may also be increased. Subscribe to AHFS Clinical Drug Information to get direct access to integrated drug shortages content, plus comprehensive and actionable drug information. Management: When amifostine is used at chemotherapy doses, blood pressure lowering medications should be withheld for 24 hours prior to amifostine administration. Primary prevention of sudden cardiac death due to ventricular arrhythmiasb. Avoid combination, Fexinidazole [INT]: Bradycardia-Causing Agents may enhance the arrhythmogenic effect of Fexinidazole [INT]. See manufacturer's labeling. The amiodarone can increase the levels of Viagra, so a lower dose may achieve the same effect. Nexterone is available as premixed solutions. Consider therapy modification, DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine. If combined, monitor for QTc interval prolongation and ventricular arrhythmias. Saquinavir may increase the serum concentration of Amiodarone. Although not all of these side effects may occur, if they do occur they may need medical attention. 10. Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Note: Prolongation of the corrected QT interval was more likely in infants <9 months of age who received higher loading doses (20 mg/kg/day vs 10 mg/kg/day in 2 divided doses) (n=50; mean age: 1 1.5 months) (Etheridge 2001). Patients with additional risk factors for QTc prolongation may be at even higher risk. Management: Decrease the adult betrixaban dose to an initial single dose of 80 mg followed by 40 mg once daily if combined with a P-glycoprotein inhibitor. The electrophysiological actions of amiodarone are complex and incompletely understood. Monitor therapy, Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Gray hair in young men-the causes of the appearance of Depression in men Dealing with depression or anxiety is a lot of work and asking for help in such a situation is not a sign of weakness, it is a sign of . Sustained monomorphic ventricular tachycardia, hemodynamically stable (off-label use): IV: Initial: 150 mg over 10 minutes, then 1 mg/minute for 6 hours, followed by 0.5 mg/minute for at least 18 hours or until switched to oral therapy (see Switching to Oral Amiodarone after IV Administration). Specifically, desethylamiodarone concentrations may decrease. Monitor therapy, ARIPiprazole: CYP2D6 Inhibitors (Weak) may increase the serum concentration of ARIPiprazole. Monitor therapy, Siltuximab: May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Monitor therapy, Lofepramine: May enhance the arrhythmogenic effect of Amiodarone. ASHP and the University of Utah make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information, and specifically disclaim all such warranties. No specific guidelines available. Management: If concurrent use cannot be avoided, reduce talazoparib dose to 0.75 mg once daily. Pharmacologic cardioversion (off-label use) (alternative agent): Note: Although amiodarone may slow ventricular response, the use of amiodarone (both IV and oral) is not particularly effective for cardioversion of atrial fibrillation to normal sinus rhythm as compared to other antiarrhythmics (eg, flecainide). Avoid combination, Probucol: QT-prolonging Agents (Highest Risk) may enhance the QTc-prolonging effect of Probucol. What is amiodarone? Monitor therapy, P-glycoprotein/ABCB1 Inducers: May decrease the serum concentration of P-glycoprotein/ABCB1 Substrates. Consider therapy modification, Encorafenib: May enhance the QTc-prolonging effect of QT-prolonging Agents (Highest Risk). Note: If amiodarone was not given during resuscitation but return of spontaneous circulation is achieved, some experts recommend empiric antiarrhythmic therapy with amiodarone (Podrid 2019). Slow the infusion rate if hypotension or bradycardia develops. Patients with other risk factors (eg, older age, female sex, bradycardia, hypokalemia, hypomagnesemia, heart disease, and higher drug concentrations) are likely at greater risk for these toxicities. Extravasation: May be a vesicant; ensure proper needle or catheter placement prior to infusion. Avoid combination, Inotuzumab Ozogamicin: QT-prolonging Agents (Highest Risk) may enhance the QTc-prolonging effect of Inotuzumab Ozogamicin. Consider therapy modification, Ubrogepant: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Ubrogepant. Napumpujte ho antioxidantmi a vitamnmi! Some experts suggest a total oral load of ~6 to 10 g (Giardina 2019). Any application of this information for any purpose shall be limited to personal, non-commercial use. share. Maintenance dose: 100 to 200 mg daily (ACC/AHA/HRS [Page 2015]). The tour begins on Aug. 3 in Sterling . Are there any hospitals out of amiodarone IV due to the shortage, and what protocols (if any) for that? Monitor therapy, Phenytoin: May decrease the serum concentration of Amiodarone. Avoid combination, Agalsidase Beta: Amiodarone may diminish the therapeutic effect of Agalsidase Beta. CAST trial: In the Cardiac Arrhythmia Suppression Trial (CAST), recent (>6 days but <2 years ago) myocardial infarction patients with asymptomatic, nonlife-threatening ventricular arrhythmias did not benefit and may have been harmed by attempts to suppress the arrhythmia with flecainide or encainide. Monitor therapy, Beta-Blockers: Amiodarone may enhance the bradycardic effect of Beta-Blockers. He armed himself with a balaclava, latex gloves, condoms and Viagra pills and posed as a cab driver in a Mercedes to roam the streets of Brighton, East Sussex. Amiodarone can exacerbate arrhythmias. "Vitamn C njdete v ovoc, ako s pomarane a jahody, a vitamn E v . Amiodarone may enhance the QTc-prolonging effect of Ceritinib. If used, administer the P-gp inhibitor simultaneously with or after the dose of afatinib. Also see Switching to oral amiodarone after IV administration. Patients with other risk factors (eg, older age, female sex, bradycardia, hypokalemia, hypomagnesemia, heart disease, and higher drug concentrations) are likely at greater risk for these toxicities. Monitor therapy, ARIPiprazole: CYP3A4 Inhibitors (Weak) may increase the serum concentration of ARIPiprazole. AuroMedics discontinued amiodarone in mid-2021. With amiodarone, however, things are quite different. Fosphenytoin may decrease the serum concentration of Amiodarone. Electrolyte imbalance: Correct electrolyte disturbances, especially hypokalemia, hypomagnesemia, or hypocalcemia, prior to use and throughout therapy. Avoid combination, Lemborexant: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Lemborexant. Avoid combination, Escitalopram: QT-prolonging Agents (Highest Risk) may enhance the QTc-prolonging effect of Escitalopram. Patients with additional risk factors for QTc prolongation may be at even higher risk. Drugs in short supply often include sterile injectables and potentially life-saving oncology (cancer) treatments. Signs of a significant reaction like wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat. Patients with other risk factors (eg, older age, female sex, bradycardia, hypokalemia, hypomagnesemia, heart disease, and higher drug concentrations) are likely at greater risk for these toxicities. Patients with additional risk factors for QTc prolongation may be at even higher risk. Updated June 5, 2023 by Michelle Wheeler, PharmD, Drug Information Specialist. Perfusing tachycardias: Infants, Children, and Adolescents: IV, Intraosseous: Loading dose: 5 mg/kg (maximum: 300 mg/dose) over 20 to 60 minutes; may repeat twice up to maximum total dose of 15 mg/kg during acute treatment (PALS [Kleinman 2010]). Management: Monitor for increased serum concentrations and/or toxicity of cyclosporine if combined with amiodarone. Thrombocytopenia, ascites, pulmonary deterioration, and renal and hepatic failure have been reported in premature neonates after receiving parenteral products containing polysorbate 80 (Alade 1986; CDC 1984). Monitor therapy, Larotrectinib: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Larotrectinib. 6th ed. 1- to 2-week IV infusion: 400 to 800 mg daily in divided doses until loading dose of ~6 to 10 g has been administered, then start maintenance dose of 200 to 400 mg once daily (depending on indication). QT-prolonging Moderate CYP3A4 Inhibitors (Moderate Risk) may increase the serum concentration of Amiodarone. Baxter had Nexterone premixed bags on shortage due to manufacturing delays. Consider therapy modification, Lopinavir: May enhance the QTc-prolonging effect of Amiodarone. Photo: Andreas Neumann. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Infusions >2 hours must be administered in a non-PVC container (eg, glass or polyolefin). You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine. Various IV and oral regimens have been described and may be used clinically. Other side effects of this drug: Talk with your doctor right away if you have any of these signs of: Note: This is not a comprehensive list of all side effects. Management: Avoid coadministration of siponimod with drugs that may cause bradycardia. Note: Amiodarone is a preferred antiarrhythmic for patients with structural heart disease. Based on the AHA/ACC/HRS guideline for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death and the European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society expert consensus on ventricular arrhythmias, amiodarone is a treatment option for symptomatic, nonsustained VT. A beta-blocker or nondihydropyridine calcium channel blocker (eg, diltiazem) is recommended prior to starting antiarrhythmic agents for this use. This helps keep your heart rhythm normal. Patients with additional risk factors for QTc prolongation may be at even higher risk. Note: Dividing the 5 mg/kg loading dose into 1 mg/kg aliquots (each administered over 5 to 10 minutes) has been used; an additional 1 to 5 mg/kg loading dose was given in the same manner, if needed, after 30 minutes (Perry 1996). Monitor therapy, Domperidone: QT-prolonging Agents (Highest Risk) may enhance the QTc-prolonging effect of Domperidone. Cardiovascular (CV) drug shortages rank among the top 5 drug classes for active drug shortages nationally and, there-fore, pose a major threat to patient care and public health. Consider therapy modification, QT-prolonging Miscellaneous Agents (Highest Risk): May enhance the QTc-prolonging effect of Amiodarone. Prevention of postoperative atrial fibrillation and atrial flutter associated with cardiothoracic surgery (off-label use) (alternative agent): Note: Some experts recommend the use of beta-blockers instead of amiodarone; however, in patients who cannot receive beta-blockers, amiodarone may be used. Amiodarone oral tablet is a prescription drug that's available as. Patients with other risk factors (eg, older age, female sex, bradycardia, hypokalemia, hypomagnesemia, heart disease, and higher drug concentrations) are likely at greater risk for these toxicities. Grapefruit Juice may increase the serum concentration of Amiodarone. Management: Consider alternatives to this combination. There is no need to protect solutions from light during administration. Monitor therapy, Lacosamide: Bradycardia-Causing Agents may enhance the AV-blocking effect of Lacosamide. Consider therapy modification, Droperidol: QT-prolonging Agents (Highest Risk) may enhance the QTc-prolonging effect of Droperidol. Management: Consider alternatives to this combination. Avoid combination, Lefamulin: May enhance the QTc-prolonging effect of QT-prolonging CYP3A4 Substrates. Management: Consider alternatives to cimetidine. EPIFOAM (hydrocortisone acetate 1% and pramoxine hydrochloride 1%) Topical Aerosol. Avoid combination, Loratadine: Amiodarone may increase the serum concentration of Loratadine. Management: The maximum recommended dosage of lemborexant is 5 mg, no more than once per night, when coadministered with weak CYP3A4 inhibitors. Hypothyroidism (sometimes severe) may be primary or subsequent to resolution of preceding amiodarone-induced hyperthyroidism; myxedema (may be fatal) has been reported. Amiodarone (administered either maternally or directly to the fetus) may be considered for the in utero management of fetal atrial flutter and in life-threatening cases of sustained fetal supraventricular tachycardia refractory to first and second line agents, but because of potential toxicity, risks and benefits should be assessed (AHA [Donofrio 2014]; Kang 2015). May be a vesicant; ensure proper needle or catheter placement prior to and during IV infusion. If hyper- or hypothyroidism occurs, reduce dose or discontinue amiodarone. May cause optic neuropathy and/or optic neuritis resulting in visual impairment (peripheral vision loss, changes in acuity) at any time during therapy; permanent blindness has occurred. Drug shortages can have a significant impact on patient care and public health. Discontinue amiodarone if the patient experiences signs or symptoms of clinical liver injury. Consider therapy modification, Sodium Stibogluconate: QT-prolonging Agents (Highest Risk) may enhance the QTc-prolonging effect of Sodium Stibogluconate. 12 It also has been shown to have use-dependent class I activity, inhibition of the inward sodium currents, 13 14 and class II activity. Periodic 100 mg dose reductions were made at 6-weekly intervals until there were signs of exacerbation or recurrence of the arrhythmia or until a daily . Prevention of postoperative atrial fibrillation and atrial flutter associated with cardiothoracic surgeryyes. This does not include most patients with allergic reactions to shellfish or contrast media, which are usually not due to iodine itself (Beall 2007; Brouse 2005; Lakshmanadoss 2012). Amiodarone may increase the serum concentration of Vitamin K Antagonists. Breastfeeding Npoje s vysokm obsahom antioxidantov, ako s vitamny C a E, preukzatene zlepuj erektiln funkciu tm, e brnia pokodeniu buniek, produkujcich oxid dusnat," hovor Pearlmanov. Consider therapy modification, MiFEPRIStone: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Monitor therapy, Obinutuzumab: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Source: Wolters Kluwer Health. Monitor therapy, QT-prolonging Class IA Antiarrhythmics (Highest Risk): May enhance the QTc-prolonging effect of Amiodarone. Incompatible with heparin; flush with saline prior to and following infusion. Monitor therapy, Ombitasvir, Paritaprevir, Ritonavir, and Dasabuvir: May increase the serum concentration of Amiodarone. Possibly to the point of cardiac arrest. Hypotension with rapid administration has been attributed to the emulsifier polysorbate 80. save. Mean daily doses >2.1 g/day have been associated with hypotension. Consider therapy modification, Entrectinib: May enhance the QTc-prolonging effect of QT-prolonging Agents (Highest Risk). $ 169 - $ 430. Management: Consider alternatives to this combination. Monitor therapy, Nitroprusside: Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside. Extravasation management: If extravasation occurs, stop infusion immediately and disconnect (leave needle/cannula in place); gently aspirate extravasated solution (do NOT flush the line); initiate hyaluronidase antidote for refractory cases (Reynolds 2014); remove needle/cannula; apply dry warm compresses (Reynolds 2014); elevate extremity. Monitor therapy, VinCRIStine (Liposomal): P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of VinCRIStine (Liposomal). Change in vision such as blurry vision, seeing halos around lights, vision loss. Monitor therapy, Dabrafenib: May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). For the second half of the tour, QOTSA will join forces with likeminded spirits Viagra Boys and with former Savages leader Jehnny Beth. Note: In this setting, administering undiluted is preferred (Dager 2006; Hazinski 2015; Skrifvars 2004). The drug prevents the recurrence of life-threatening ventricular arrhythmias and. Also see Switching to Oral Amiodarone after IV Administration. Avoid combination, Vitamin K Antagonists (eg, warfarin): Amiodarone may enhance the anticoagulant effect of Vitamin K Antagonists. Amiodarone is intended for use only in patients with indicated life-threatening arrhythmias because its use is accompanied by substantial toxicity. Patients with additional risk factors for QTc prolongation may be at even higher risk. Management: Seek alternatives when possible. Consider therapy modification, Aminolevulinic Acid (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Systemic). If combined, monitor for QTc interval prolongation and ventricular arrhythmias. Consider therapy modification, Lomitapide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Lomitapide. Specifically, the risk of pulmonary toxicity may be enhanced. Some combinations may be specifically contraindicated. Management: Reduce afatinib by 10 mg if not tolerated. Management: Consider alternatives to this combination. Brand names: Cordarone, Pacerone, Cordarone IV, Nexterone. If combined, limit the adult simvastatin dose to 20 mg daily and monitor for evidence of simvastatin toxicities (eg, myalgia, liver function test elevations, rhabdomyolysis). Ocular effects: Regular ophthalmic examination (including slit lamp and fundoscopy) is recommended. Fildena Super Active. Heart failureshortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue. Some non-US labeling recommends avoiding combination if possible. Monitor therapy, PAZOPanib: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of PAZOPanib. Monitor therapy, Erdafitinib: May increase the serum concentration of P-glycoprotein/ABCB1 Substrates. Management: Consider alternatives to this combination. Consult appropriate manufacturer labeling. Management: Consider alternatives to this drug combination. Patients with other risk factors (eg, older age, female sex, bradycardia, hypokalemia, hypomagnesemia, heart disease, and higher drug concentrations) are likely at greater risk for these toxicities. Excipient information presented when available (limited, particularly for generics); consult specific product labeling. If diagnosis of optic neuropathy and/or optic neuritis is confirmed, reevaluate amiodarone therapy. Corneal refractive laser surgery is generally contraindicated in amiodarone users (from manufacturers of surgical devices). Monitor therapy, Simeprevir: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Amiodarone and the active metabolite, N-desethylamiodarone, cross the placenta (Plomp 1992). Based on the ACC/AHA/HRS guideline for the management of patients with supraventricular tachycardia, amiodarone may be considered in the ongoing management of symptomatic supraventricular tachycardia (atrioventricular nodal reentrant tachycardia or atrioventricular reentrant tachycardia) or in the acute or ongoing management of focal atrial tachycardia; however, safety risks limit its therapeutic use. In a recent publication in this journal ( 2 ), I gave a plausible scientific explanation of how erectile dysfunction drugs can derange the optic nerve head circulation and produce non-arteritic anterior ischemic optic neuropathy (NAION). Supraventricular tachycardia (eg, atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia, focal atrial tachycardia) (off-label use): Note: Amiodarone is usually reserved for use when other therapies have failed or are contraindicated. Ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT), shock-refractory: Infants, Children, and Adolescents: IV, Intraosseous: 5 mg/kg (maximum: 300 mg/dose) rapid bolus; may repeat twice up to a maximum total dose of 15 mg/kg during acute treatment (PALS [de Caen 2015]; PALS [Duff 2018]; PALS [Kleinman 2010]). Consider therapy modification, CYP2C8 Inhibitors (Strong): May increase the serum concentration of Amiodarone. Alternative means of dosing and administration (1 mg/kg aliquots) may need to be considered. Blood pressure, heart rate (ECG) and rhythm throughout therapy; assess patient for signs of lethargy, edema of the hands or feet, weight loss, and pulmonary toxicity (baseline pulmonary function tests and chest X-ray; continue monitoring chest X-ray annually during therapy); liver function tests (semiannually); monitor serum electrolytes, especially potassium and magnesium. Note: IV administration at lower flow rates (potentially associated with use in pediatrics) and higher concentrations than recommended may result in leaching of plasticizers (DEHP) from intravenous tubing. Monitor therapy, Everolimus: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Everolimus. For peripheral infusions, an in-line filter has been recommended during administration to reduce the incidence of phlebitis (consult individual institutional policies and procedures). 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