| Indications | Loading dose | Maintenance dose |
| Atrial arrhythmias |
- Prevention of recurrent PAF
- Pharmacologic cardioversion of PAF
| - Total loading dose: 6 to 10 grams
- Outpatient: Given as 400 to 600 mg orally per day in divided doses with meals
- Inpatient: Given as 400 to 1200 mg orally per day in divided doses with meals
| - Lowest effective dose, usually 100 to 200 mg orally once per day
- Maximum 200 mg orally per day
|
- Pretreatment before elective cardioversion or catheter ablation of AF
| - Total loading dose: 6 to 10 grams orally over 2 to 6 weeks
- Given as 400 to 1200 mg orally per day in divided doses
| - Lowest effective dose, usually 100 to 200 mg orally once per day
- Maximum 400 mg orally per day in most circumstances
|
- Restoration and maintenance of NSR in critically ill patients with AF
- Ventricular rate control in critically ill patients with AF and rapid ventricular response
| - Total IV loading dose: 1050 mg
- Given as 150 mg IV bolus over 10 to 30 minutes, followed by continuous IV infusion at 1 mg per minute for 6 hours, then 0.5 mg per minute for 18 hours*
- IV infusion (0.5 mg per minute) may need to be extended past 24 hours if unable to transition to oral therapy
- If amiodarone will be used chronically: Following IV infusion, give 400 to 1200 mg orally per day in divided doses to complete a total (IV plus oral) loading dose of 10 grams; consider overlapping IV and oral amiodarone for 24 to 48 hours
| |
| Ventricular arrhythmias |
- Primary and secondary prevention of SCD in patients with LV dysfunction who are not candidates for or refuse ICD implantation
| - Total oral loading dose: 6 to 10 grams
- Outpatient: 400 to 600 mg orally per day in divided doses with meal
- Inpatient: 400 to 1200 mg orally per day in divided doses with meals for 1 to 2 weeks
| - Maximum 400 mg orally per day in most circumstances
- Lowest effective dose, ideally 200 mg or less orally once per day or in divided doses
|
- Prevention of ventricular arrhythmias in patients with ICDs to decrease risk of shocks
| - Total loading dose: 6 to 10 grams
- Outpatient: Given as 400 to 600 mg orally per day in divided doses with meals
- Inpatient: Given as 400 to 1200 mg orally per day in divided doses with meals until desired dose is achieved
| - Maximum 400 mg orally per day in most circumstances
- Lowest effective dose, ideally 200 mg or less orally per day
|
- Cardiac arrest associated with VF or pulseless VT
| - 300 mg IV or IO rapid bolus with a repeat dose of 150 mg as indicated
- Upon return of spontaneous circulation follow with an infusion of 1 mg per minute for 6 hours and then 0.5 mg per minute for 18 hours*
| |
- Electrical (VT) storm and incessant VT in hemodynamically stable patients
| - Total IV loading dose: 1050 mg
- 150 mg IV bolus over 10 minutes, followed by continuous IV infusion at 1 mg per minute for 6 hours, then 0.5 mg per minute for 18 hours
- IV infusion (0.5 mg per minute) may need to be extended past 24 hours if unable to transition to oral therapy¶
- Additional 150 mg boluses may be given if VT storm recurs
- If amiodarone will be used chronically: Following IV infusion 400 to 1200 mg orally per day in divided doses to complete a total (IV plus oral) loading dose of 10 grams. Consider overlapping IV and oral amiodarone for 24-48 hours
| - If amiodarone is used chronically: Lowest effective dose, ideally 200 mg or less orally per day; maximum 400 mg orally per day in most circumstances
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