Amiodarone
Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026
Amiodarone is the most effective antiarrhythmic drug available, possessing properties of all four Vaughan-Williams antiarrhythmic classes. It is used for life-threatening ventricular arrhythmias and atrial fibrillation. However, its extensive side effect profile including thyroid, pulmonary, hepatic, and ocular toxicity requires careful long-term monitoring.
Exploratory record, not a reviewed medical publication.
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This generated database record has not completed a claim-level review by a qualified human medical reviewer. Bibliography links and evidence labels are not approval. The page remains available for reference and is excluded from search indexing.
What the research says.
A quick, data-only summary. The full evidence, dosing, and sources are below.
Amiodarone is the most effective antiarrhythmic drug available, possessing properties of all four Vaughan-Williams antiarrhythmic classes. NutriStack rates the supporting evidence as strong. Common adult dosing is Loading: 400–800 mg daily for 1–3 weeks; Maintenance: 100–400 mg daily (as prescribed by your physician), though a prescriber sets the actual dose. This profile indexes 9 sources.
- Pulmonary toxicity (pneumonitis, fibrosis, potentially fatal)
- Thyroid dysfunction (hypothyroidism 6%, hyperthyroidism 0.9–2%)
- Hepatotoxicity (elevated LFTs, cirrhosis)
- Cardiogenic shock5
- Severe sinus node dysfunction or second/third-degree AV block without pacemaker
The bottom line
Evidence rating strong. Most-documented uses: most effective antiarrhythmic for ventricular and atrial arrhythmias, reduces mortality from ventricular arrhythmias (meta-analyses), maintains sinus rhythm in atrial fibrillation. 9 sources indexed (2017–2024), with 0 interaction records on file.
How it works, mechanistically.
Core mechanism
Primarily a class III antiarrhythmic (potassium channel blocker) that prolongs the action potential duration and effective refractory period. Also exhibits class I (sodium channel blocking), class II (non-competitive beta-blocking), and class IV (calcium channel blocking) activity. Contains iodine (37% by weight), which contributes to thyroid effects. Extremely lipophilic with massive tissue distribution.
Dosing & protocol.
Food increases absorption; extremely long tissue loading period; avoid grapefruit juice
Full safety detail.
Side effects
- Pulmonary toxicity (pneumonitis, fibrosis, potentially fatal)
- Thyroid dysfunction (hypothyroidism 6%, hyperthyroidism 0.9–2%)
- Hepatotoxicity (elevated LFTs, cirrhosis)
- Corneal microdeposits (>90% of patients, usually asymptomatic)
- Optic neuropathy (rare)
- Photosensitivity and blue-gray skin discoloration
- Peripheral neuropathy
- Bradycardia and QT prolongation
Sources, by evidence tier.
Numbered references. Citations throughout the page link here.
Meta-analyses & systematic reviews
5- 1The roles of thyroidectomy in patients with amiodarone-induced thyrotoxicosis: A systematic reviewPMIDWidiarti W, Saputra PBT, Mustofa A et al. · Current problems in cardiology · 2024
Widiarti W, Saputra PBT, Mustofa A et al.. The roles of thyroidectomy in patients with amiodarone-induced thyrotoxicosis: A systematic review. Current problems in cardiology. 2024
- 2Prevalence of amiodarone-induced hypothyroidism; A systematic review and meta-analysisPMIDMohammadi K, Shafie D, Vakhshoori M et al. · Trends in cardiovascular medicine · 2023
Mohammadi K, Shafie D, Vakhshoori M et al.. Prevalence of amiodarone-induced hypothyroidism; A systematic review and meta-analysis. Trends in cardiovascular medicine. 2023
- 3Ocular Adverse Effects of Amiodarone: A Systematic Review of Case ReportsPMIDAlshehri M, Joury A · Optometry and vision science : official publication of the American Academy of Optometry · 2020
Alshehri M, Joury A. Ocular Adverse Effects of Amiodarone: A Systematic Review of Case Reports. Optometry and vision science : official publication of the American Academy of Optometry. 2020
- 4Meta-Analysis Comparing the Relative Risk of Adverse Events for Amiodarone Versus PlaceboPMIDRuzieh M, Moroi MK, Aboujamous NM et al. · The American journal of cardiology · 2019
Ruzieh M, Moroi MK, Aboujamous NM et al.. Meta-Analysis Comparing the Relative Risk of Adverse Events for Amiodarone Versus Placebo. The American journal of cardiology. 2019
- 5Amiodarone, lidocaine, magnesium or placebo in shock refractory ventricular arrhythmia: A Bayesian network meta-analysisPMIDKhan SU, Winnicka L, Saleem MA et al. · Heart & lung : the journal of critical care · 2017
Khan SU, Winnicka L, Saleem MA et al.. Amiodarone, lidocaine, magnesium or placebo in shock refractory ventricular arrhythmia: A Bayesian network meta-analysis. Heart & lung : the journal of critical care. 2017
Reference material
4- 6Amiodarone Trials Meta-Analysis Investigators. Effect of prophylactic amiodarone on mortality after acute myocardial infarction and in congestive heart failure: meta-analysis. Lancet. 1997.Source linkedPMID
- 7Roy D et al. Amiodarone to prevent recurrence of atrial fibrillation (CTAF). N Engl J Med. 2000.Source linkedPMID
- 8Papiris SA, Triantafillidou C, Kolilekas L et al.. Amiodarone: review of pulmonary effects and toxicity. Drug safety. 2010Source linkedPMID
- 9Chen D, Hedges TR. Amiodarone optic neuropathy--review. Seminars in ophthalmology. 2003Source linkedPMID
Common questions.
Quick answers about Amiodarone, drawn from the data on this page.
What is Amiodarone?
Amiodarone is the most effective antiarrhythmic drug available, possessing properties of all four Vaughan-Williams antiarrhythmic classes. It is used for life-threatening ventricular arrhythmias and atrial fibrillation. However, its extensive side effect profile including thyroid, pulmonary, hepatic, and ocular toxicity requires careful long-term monitoring.
What is Amiodarone used for?
Commonly cited benefits of Amiodarone include: Most effective antiarrhythmic for ventricular and atrial arrhythmias; Reduces mortality from ventricular arrhythmias (meta-analyses); Maintains sinus rhythm in atrial fibrillation; Minimal negative inotropic effect (safer in heart failure than most antiarrhythmics). NutriStack rates the overall evidence as strong.
What is a typical dose of Amiodarone?
A typical adult dose of Amiodarone is Loading: 400–800 mg daily for 1–3 weeks; Maintenance: 100–400 mg daily (as prescribed by your physician). The commonly recommended form is Oral tablet or IV infusion. These are general ranges, not personalized advice; confirm the right dose with a clinician.
What are the side effects of Amiodarone?
Reported side effects include pulmonary toxicity (pneumonitis, fibrosis, potentially fatal), thyroid dysfunction (hypothyroidism 6%, hyperthyroidism 0.9–2%), hepatotoxicity (elevated lfts, cirrhosis), corneal microdeposits (>90% of patients, usually asymptomatic), optic neuropathy (rare), photosensitivity and blue-gray skin discoloration. This is educational information; check with a healthcare professional before use.
How strong is the evidence for Amiodarone?
NutriStack rates this as Strong, meaning multiple high-quality meta-analyses or systematic reviews converge on the same finding. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.
Use this with your stack
Amiodarone in NutriStack.
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