Interactions

Drug-Drug

• Increased risk of QT prolongations with fluoroquinolones, macrolides, and azole antifungals (undertake concurrent use with caution)

• blood levels and may lead to toxicity from digoxin ( dose of digoxin by 50%)

• blood levels and may lead to toxicity from other class I antiarrhythmics (quinidine, procainamide, mexiletine, lidocaine, or flecainide — doses of other drugs by 30–50%)

• blood levels of cyclosporine, dextromethorphan, methotrexate, phenytoin, and theophylline

• Phenytoin amiodarone blood levels

• activity of warfarin ( dose of warfarin by 33–50%)

• risk of bradyarrhythmias, sinus arrest, or AV heart block with beta blockers or calcium channel blockers

• Cholestyramine may amiodarone blood levels

• Cimetidine and ritonavir amiodarone blood levels

• Risk of myocardial depression is by volatile anesthetics

Drug-Natural Products
St. John's wort induces enzymes that metabolize amiodarone; may levels and effectiveness. Avoid concurrent use

Drug-Food
Grapefruit juice inhibits enzymes in the GI tract that metabolize amiodarone resulting in levels and risk of toxicity; avoid concurrent use

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