Amiodarone for abnormal heart rhythms
Amiodarone for abnormal heart rhythms
This leaflet is about the use of amiodarone for abnormal heart rhythms (heart beats).
This leaflet has been written for parents and carers about how to use this medicine in children. Our information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adult patients. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.
Name of drug
Brand name: Cordarone X®
Why is it important for my child to take this medicine?
Amiodarone belongs to a group of medicines called antiarrhythmics. It works by controlling the irregular (uneven) beating of your child’s heart. Your child needs to take amiodarone regularly to help their heart beat return to normal.
What is amiodarone available as?
- Tablets: 100 mg, 200 mg
- Liquid medicine can be ordered specially from your pharmacist
When should I give amiodarone?
Amiodarone may be given once, twice or three times each day. Your doctor will tell you how often to give it.
- Once a day: this can be in the morning OR the evening.
- Twice a day: this should be once in the morning and once in the evening. Ideally, these times are 10–12 hours apart, for example some time between 7 and 8am, and between 7 and 8 pm.
- Three times each day: this should be once in the morning, once in the early afternoon and once in the evening. Ideally, these times are at least 6 hours apart, for example 8 am, 2 pm and 8 pm.
Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.
How much should I give?
Your doctor will work out the amount of amiodarone (the dose) that is right for your child. The dose will be shown on the medicine label.
Your doctor will probably start your child on a high dose then gradually change it over the first few weeks to get the correct level in their blood. Do not change the dose without talking to your doctor first.
It is important that you follow your doctor’s instructions about how much to give.
How should I give it?
Tablets should be swallowed with a glass of water, milk or juice. Your child should not chew the tablet.
You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey or jam. Make sure your child swallows it straight away, without chewing if possible.
Liquid medicine: Measure out the right amount using a an oral syringe or medicine spoon. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount. Make sure your child takes it all straight away.
When should the medicine start working?
It usually takes a couple of weeks for amiodarone to work, so you will not see much difference in your child to start with. Continue to give the medicine to your child during this time. If you are worried about whether it is helping, contact your doctor but do not stop giving the amiodarone.
What if my child is sick (vomits)?
- If your child is sick less than 5 minutes after having a dose of amiodarone, give them the same dose again.
- If your child is sick more than 5 minutes after having a dose of amiodarone, you do not need to give them another dose. Wait until the next normal dose.
If your child is sick again, seek advice from your GP, pharmacist or hospital. They will decide what to do based on your child’s condition and the medicine.
What if I forget to give it?
If you usually give it once a day in the morning: Give the missed dose when you remember during the day, as long as this is at least 12 hours before the next dose is due.
If you usually give it once a day in the evening: If you remember before bedtime, give the missed dose. You do not need to wake up a sleeping child to give a missed dose. You can give the missed dose in the morning, as long as this is at least 12 hours before the evening dose is due.
If you usually give it twice a day: If you remember up to 4 hours after you should have given a dose, give your child the missed dose. For example, if you usually give a dose at about 7 am, you can give the missed dose at any time up to 11 am. If you remember after that time, do not give the missed dose. Just give the next dose as usual.
If you usually give it three times a day: Do not give the missed dose. Just give the next dose as usual.
Never give a double dose of amiodarone.
What if I give too much?
It may be dangerous to give too much amiodarone.
If your child has any, or all, of the following symptoms they may have had too much amiodarone: feeling dizzy, faint, tired or confused, being sick, stomach pain or a slow heart rate.
If you think you may have given your child too much amiodarone contact your doctor or local NHS services (111 in parts of England; 0845 4647 in parts of England and in Wales; 08454 24 24 24 in Scotland) or take your child to hospital.
Take the medicine container or packaging with you, even if it is empty. This will be useful to the doctor. Have the medicine or packaging with you if you telephone for advice.
Are there any possible side-effects?
We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).
Side-effects you must do something about
If your child is short of breath or is wheezing, or their face, lips or tongue start to swell, or they develop a rash, they may be allergic to amiodarone. Take your child to hospital or call an ambulance straight away.
If your child’s heart beat becomes more uneven, or becomes very slow (signs to look out for include feeling faint, dizzy, unusually tired and short of breath), take your child to hospital or call an ambulance straight away.
If your child starts being sick every few hours, has stomach pains or a fever (temperature above 38°C), is very sleepy or gets a yellowish tinge to the skin or whites of the eyes, stop giving amiodarone and contact your doctor or take your child to hospital straight away, as there may be a problem with your child’s liver.
If your child loses eyesight in one eye, their eye balls become dim and colourless, or their eyes are sore and painful to move, stop giving amiodarone and see a doctor or take your child to hospital straight away.
If your child has difficulty breathing, complains of a tight chest, has constant coughing, coughs up blood or is wheezy, stop giving amiodarone and contact your doctor or take your child to hospital straight away.
Other side-effects you need to know about
Your child’s skin may become more sensitive to sunlight. When outdoors, they should wear a long-sleeved top, trousers and a hat and should use a high-factor sunscreen on exposed skin (at least SPF 30). Keep them out of strong sunlight.
- Contact your doctor as soon as possible if your child:
• develops blurred eyesight or complains of seeing a coloured ‘halo’ in dazzling lights
• starts to feel very restless or agitated, loses weight and sweats more than normal; these could be signs of hyperthyroidism (too much thyroid hormone)
• starts to feel very tired, weak or generally ‘run down’, gains weight, becomes constipated and complains of aching muscles; these could be signs of hypothyrodism (not enough thyroid hormone).
- Your child’s skin may turn a slate-grey colour. This is nothing to worry about but if you are concerned contact your doctor.
There may, sometimes, be other side-effects. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side-effects to a UK safety scheme at http://yellowcard.mhra.gov.uk.
Can other medicines be given at the same time?
- You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
- Amiodarone should not be taken with some medicines that you get on prescription. Tell your doctor and pharmacist about any other medicines your child is taking before giving amiodarone. This includes herbal or complementary medicines.
Is there anything else I need to know?
- Your child’s doctor will test your child’s blood regularly to check that amiodarone has not affected their liver or thyroid gland.
- If your child needs any other treatments, you must tell the doctor, pharmacist, nurse or dentist that your child is taking amiodarone. It is also important to tell them for several months after your child has stopped taking amiodarone, as the medicine stays in the body for a long time.
General advice about medicines
- Try to give medicines at about the same times each day, to help you remember.
- If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.
- Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.
If you think someone else may have taken the medicine by accident, contact your doctor straight away.
- Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
- Make sure that the medicine you have has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.
Where should I keep this medicine?
- Keep the medicine in the container it came in, in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
- Make sure that children cannot see or reach it.
Who to contact for more information
Your doctor, pharmacist or nurse will be able to give you more information about amiodarone and other medicines used to treat abnormal heart rhythms.
Version 1, November 2013. © NPPG, RCPCH and WellChild 2011, all rights reserved. Reviewed by: November 2016.
The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk
We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.