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Indication & Dosage |
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| Intravenous |
| VENTRICULAR AND SUPRAVENTRICULAR ARRHYTHMIAS INCLUDING THOSE ASSOCIATED WITH WOLFF-PARKINSON-WHITE SYNDROME |
| Adult:
Initially, 5 mg/kg in 250 ml of 5% glucose, infused over 20-120 minutes with ECG monitoring. To be given via central venous catheter. Max dose: 1.2 g in 24 hr. |
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| Oral |
| VENTRICULAR AND SUPRAVENTRICULAR ARRHYTHMIAS INCLUDING THOSE ASSOCIATED WITH WOLFF-PARKINSON-WHITE SYNDROME |
| Adult:
Initially, 200 mg tid for 1 wk decreased to 200 mg bid for the next wk. Maintenance: Usually 200 mg daily or the min dose to control arrhythmia. |
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| Administration |
May be taken with or without food. (Take consistently w/ or without meals. Take w/ meals if high dose or to reduce GI discomfort.) |
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| Precautions |
Monitor thyroid, pulmonary and liver functions, opthalmological exam performed annually, patients with heart failure, elderly. Avoid sunlight exposure. |
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Potentially Life-threatening
Adverse Drug Reactions |
Blue-grey discolouration of skin, photosensitivity, peripheral neuropathy, paraesthesia, myopathy, ataxia, tremor, nausea, vomiting, metallic taste, hypothyroidism, hyperthyroidism, alopoecia, sleep disturbances, corneal microdeposits, hot flushes, sweating. Heart block, bradycardia, sinus arrest, hepatotoxicity, heart failure. |
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| Adverse Drug Reactions |
Pulmonary toxicity including pulmonary fibrosis and interstitial pneumonitis, hepatotoxicity, thyrotoxicity. Ventricular arrhythmias, pulmonary alveolitis, exacerbation of arrhythmias and rare serious liver injury. Generally in patients with high doses and having preexisting abnormalities of diffusion capacity. |
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| Interactions |
Potentiates the effect of warfarin and other anticoagulants hence dose of warfarin generally needs to be reduced approx half. Raised plasma concentrations of digoxin, cyclosporine, phenytoin and quinidine. Additive effect with beta-blockers and calcium-channel blockers (verapamil and diltiazem). Potentiation of antiarrhythmic drugs. Increased rate and absorption with food. |
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