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CARDIOVASCULAR SYSTEM › CARDIAC THERAPY › ANTIARRHYTHMICS, CLASS I AND III › Antiarrhythmics, class III
dronedarone
C01BD07
Forms & Strengths
- Tablets: 400mg
- Tablets: 500mg (not in all countries)
- Oral administration
Adult Dosing
- 400mg twice daily
- With meals to reduce gastrointestinal side effects
- Atrial fibrillation or atrial flutter: initiate in hospital with monitoring
- Adjust dose according to renal function and other medications
Pediatric Dosing
- Not established for pediatric patients
- Avoid use in pediatric patients due to limited experience
Indications
- Atrial fibrillation: to reduce risk of cardiovascular hospitalization
- Atrial flutter: conversion to sinus rhythm and maintenance
- Paroxysmal or persistent atrial fibrillation
Mechanism of Action
- Class III anti-arrhythmic agent
- Blocks potassium channels, prolongs repolarization
- Beta-adrenergic blocking activity, calcium channel blocking activity
- Inhibiting sodium channels, reducing conduction velocity
Contraindications
- NYHA Class IV heart failure or unstable heart failure
- Second- or third-degree atrioventricular (AV) block
- Sick sinus syndrome
- Bradycardia (<50 bpm)
- Severe hepatic impairment
- Concomitant use with strong CYP3A4 inhibitors
Adverse Reactions
- Gastrointestinal: diarrhea, nausea, vomiting
- Cardiovascular: bradycardia, QT prolongation
- Hepatic: increased liver enzymes
- Renal: increased creatinine, renal failure
- Respiratory: pulmonary toxicity
Drug Interactions
- CYP3A4 inhibitors: increase dronedarone levels
- CYP3A4 inducers: decrease dronedarone levels
- Digoxin: increase digoxin levels
- Warfarin: increase INR
- Beta-blockers, calcium channel blockers: potentiate bradycardia or conduction disturbances
Curated Content: Needs Vetting Before Put to Clinical Use