This article describes possible interactions with amiodarone oral tablet. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.
Amiodarone comes as tablets that you’ll swallow. It’s also available as a solution that’s injected into your vein.
Boxed warning: Risk of lung, liver, and heart problems
Amiodarone has a boxed warning for the risk of lung, liver, and heart problems. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). See the end of this article for more information about this warning.
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Other drugs and amiodarone
The drugs in the list below may interact with amiodarone oral tablet. This article doesn’t include all drugs that may interact with amiodarone.
Drug classes or drugs that may interact with amiodarone oral tablet include:
- beta-blockers:
- certain calcium channel blockers (CCBs):
- certain antibiotics:
- drug examples: clarithromycin, levofloxacin
- what might happen: can increase the risk of an irregular heart rhythm that can lead to death
- certain antifungals:
- drug examples: ketoconazole, itraconazole (Sporanox, Tolsura)
- what might happen: can increase the risk of an irregular heart rhythm that can lead to death
- certain antipsychotics:
- drug examples: ziprasidone (Geodon), thioridazine
- what might happen: can increase the risk of side effects of amiodarone and the antipsychotic
- certain statins:
- drug examples: atorvastatin (Lipitor), simvastatin (Zocor), lovastatin (Mevacor)
- what might happen: can increase the risk of muscle pain (a possible side effect from statins)
- drugs other than amiodarone used for arrhythmias:
- drug examples: dofetilide (Tikosyn), flecainide
- what might happen: can increase the risk of an irregular heart rhythm that can lead to death, and may increase the side effects of flecainide
- protease inhibitors:
- drug examples: ritonavir (Norvir, and an ingredient in Paxlovid), darunavir (Prezista), atazanavir (Reyataz)
- what might happen: can increase the risk of side effects of amiodarone
- tricyclic antidepressants:
- drug examples: desipramine (Norpramin), amitriptyline
- what might happen: can increase the risk of an irregular heart rhythm that can lead to death
- sotalol (Betapace):
- can increase the risk of an irregular heart rhythm that may lead to death
- cobicistat (Tybost) and treatments that contain it:
- drug example: cobicistat/elvitegravir/emtricitabine/tenofovir alafenamide fumarate (Genvoya)
- what might happen: can increase the risk of side effects of cobicistat and amiodarone
- digoxin (Lanoxin):
- what might happen: can increase the risk of side effects of digoxin
- warfarin (Jantoven):
- what might happen: can significantly increase the risk of bleeding with warfarin
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When to avoid amiodarone
Certain health conditions or other factors could increase some risks with amiodarone oral tablet. Because of this, doctors may not prescribe amiodarone in these cases. These health conditions or other factors are called contraindications.
Here’s a list of contraindications for amiodarone oral tablet:
- Certain heart rhythm conditions. Doctors typically won’t prescribe amiodarone if you have certain heart rhythm conditions. This is because the drug could worsen certain heart rhythm problems. These include sick sinus syndrome, second-degree or third-degree atrioventricular (AV) block, and a slow heartbeat that causes fainting. (For a slow heartbeat that causes fainting, your doctor may prescribe amiodarone if you have a pacemaker.) See the “Boxed warning” section at the end of this article to learn about heart-related side effects amiodarone may cause.
- Cardiogenic shock. Doctors won’t prescribe amiodarone if you’re experiencing cardiogenic shock. This is a sudden, life threatening condition that requires immediate treatment in a hospital or emergency room.
- Past allergic reaction to amiodarone. If you’ve ever had an allergic reaction to amiodarone oral tablet, taking it again may cause another allergic reaction.
Before you start taking amiodarone, tell your doctor if anything listed above relates to you. They can recommend whether you should take amiodarone.
Other interactions and amiodarone
Interactions can occur with supplements, foods, vaccines, and some lab tests. Below you can learn whether amiodarone oral tablet has these interactions.
The information below doesn’t include all other possible interactions with amiodarone.
Amiodarone and supplements
Before taking amiodarone oral tablet, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Amiodarone interactions with herbs
Amiodarone oral tablet may interact with St. John’s wort. This herb is often used for easing symptoms of depression.
Taking amiodarone and St. John’s wort may make amiodarone less effective. Due to this risk, your doctor will likely recommend you don’t take St. John’s wort if you’re prescribed amiodarone.
Because of this, ask your doctor or pharmacist before taking any of these products while taking amiodarone oral tablet.
Amiodarone interactions with vitamins
Amiodarone oral tablet isn’t known to interact with any vitamins. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.
Because of this, ask your doctor or pharmacist before taking any of these products while taking amiodarone oral tablet.
Amiodarone and food
Amiodarone oral tablet can interact with grapefruit and grapefruit juice. Consuming grapefruit or grapefruit juice can increase the effect of amiodarone and its risk of side effects. Due to this risk, your doctor will likely suggest avoiding grapefruit and grapefruit juice while you’re taking amiodarone.
Amiodarone can also interact with red yeast rice supplements. Taking amiodarone can increase the risk of side effects from red yeast rice supplements. But amiodarone isn’t expected to interact with red yeast rice in foods.
Because of this, talk with your doctor or pharmacist about what foods you should avoid while taking amiodarone oral tablet.
Amiodarone and vaccines
Amiodarone oral tablet isn’t known to interact with any vaccines. But this doesn’t mean interactions with vaccines can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before receiving any vaccines while taking amiodarone oral tablet.
Amiodarone and lab tests
Amiodarone oral tablet isn’t known to interact with lab tests. But this doesn’t mean interactions with lab tests can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before having any tests while taking amiodarone oral tablet.
Amiodarone and cannabis or CBD
Studies of cannabis (commonly called marijuana) and cannabis products have been shown to interact with amiodarone.
Taking amiodarone and using cannabis can increase your risk of cannabis side effects.
Before you take amiodarone, tell your doctor and pharmacist if you use cannabis. Doing so may help prevent possible interactions.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Questions about amiodarone and interactions
Here you’ll find answers to some common questions about amiodarone and possible interactions.
Does amiodarone interact with doxycycline?
No, there’s not a known interaction between amiodarone and doxycycline.
Doxycycline is a tetracycline antibiotic that’s prescribed to treat certain infections. Amiodarone isn’t known to interact with doxycycline. But it can interact with other antibiotics. To learn more, see the “Other drugs” section in this article. Or ask your pharmacist or doctor for more information.
Can amiodarone interact with other medications even after I stop taking it?
Yes, it can. Amiodarone can interact with other medications you take for weeks or even months after your last dose of amiodarone.
This happens because amiodarone has an extremely long half-life. (A half-life describes how long it takes your body to reduce the amount of a drug in your system by half once you stop taking the drug.) Drugs that have a long half-life stay in your body longer than drugs with a short half-life.
Because amiodarone has such a long half-life, the drug remains in your system for weeks or even months after your last dose. The exact time varies depending on how long you took amiodarone and the dosage prescribed.
Because of this risk, you should continue telling your doctor and pharmacist about any new medications or supplements you start taking after you’ve stopped amiodarone. They’ll still need to check for possible interactions with amiodarone. Your doctor or pharmacist can also provide more detail on how long amiodarone may remain in your system based on your treatment length.
Alcohol and amiodarone
Amiodarone oral tablet is not known to interact with alcohol.
However, research has linked alcohol consumption with arrhythmias. And amiodarone is prescribed to treat certain ventricular arrhythmias. While alcohol hasn’t been directly connected to this type of arrhythmia, it’s possible that alcohol could trigger or worsen symptoms of your condition.
If you drink alcohol, talk with your doctor about whether it’s safe to consume it while taking amiodarone oral tablet.
Health factors and amiodarone
Certain medical conditions or other health factors may increase the risk of interactions with amiodarone oral tablet. Keep in mind that interactions could lead to side effects or affect how well the drug works. Before taking amiodarone, tell your doctor about your health history. They’ll determine whether amiodarone is right for you.
These health conditions or other factors might interact with amiodarone oral tablet:
* This condition is considered a contraindication to taking amiodarone. See the “When to avoid” section to learn more.
Preventing amiodarone interactions
You may be able to help avoid certain interactions with amiodarone oral tablet. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.
Things to consider include:
- Whether you drink alcohol or use cannabis.
- Other medications and herbs you take, as well as vitamins and supplements. Your doctor or pharmacist can help you fill out a medication list.
- What to do if you’re prescribed a new drug while taking amiodarone oral tablet.
Taking amiodarone exactly as prescribed can also help prevent interactions.
What to ask your doctor
If you have questions about amiodarone and possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Do other drugs that could treat my condition have similar interactions?
- Should I tell you if I start taking another medication or supplement during my amiodarone treatment?
- Should I let you know if I make lifestyle changes, such as to my diet or exercise routine?
Boxed warning for amiodarone
Amiodarone has a boxed warning for the risk of lung, liver, and heart problems. A boxed warning is the most serious warning from the FDA.
Treatment with amiodarone can cause serious side effects, including heart, liver, and lung-related side effects. Because of these risks, amiodarone is only prescribed to treat life threatening arrhythmias.
Here’s more information about these side effects:
- Heart-related side effects: While amiodarone is prescribed to treat certain arrhythmias, the drug may also worsen them. As a result, doctors typically will have you stay in a hospital for a short time when you first start taking amiodarone. This way, they can monitor you closely in case amiodarone worsens your arrhythmia, and they’ll be able to treat any side effects that may occur. Symptoms of heart-related side effects amiodarone may cause include fainting, rapid or pounding heartbeat, and pressure or pain in your chest.
- Liver-related side effects: Amiodarone can cause liver damage, which may be life threatening in rare cases. Symptoms of liver-related side effects amiodarone may cause include jaundice, abdominal pain, and dark-colored urine.
- Lung-related side effects: Examples include pneumonitis and lung damage, which can be life threatening in rare cases. To monitor for these, your doctor will order imaging tests and examine your lungs periodically during treatment with amiodarone. Symptoms of lung-related side effects amiodarone may cause include tightness in your chest, dry cough, and fatigue.
To learn more, talk with your doctor.
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
