Amiodarone infusion started at which rate
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amiodarone IV infusion rate loading dose maintenance mg/min
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Here is the complete amiodarone IV infusion protocol:
Amiodarone IV Infusion - Standard Protocol
For Ventricular Arrhythmias (VT/VF) - Standard 24-Hour Regimen
The total target dose is 1000 mg over the first 24 hours, given in three phases:
| Phase | Dose | Duration | Rate |
|---|---|---|---|
| 1. Initial loading bolus | 150 mg | Over 10 minutes | 15 mg/min |
| 2. Slow loading infusion | 360 mg | Over 6 hours | 1 mg/min |
| 3. Maintenance infusion | 540 mg | Over 18 hours | 0.5 mg/min |
After the first 24 hours:
- Continue maintenance at 0.5 mg/min (can be maintained for up to 3 weeks)
Breakthrough VT/VF Episodes
- Give supplemental 150 mg over 10 minutes (15 mg/min)
- The infusion rate can be increased if needed
ACLS (Cardiac Arrest - Pulseless VT/VF)
- 300 mg IV push (undiluted or diluted in 20-30 mL D5W) as a bolus
- Second dose: 150 mg IV push if VF/VT recurs
Key Safety Points
- Infusion rate must NOT exceed 30 mg/min - hypotension is dose and infusion-rate dependent
- Total daily dose must not exceed 2.2 g
- Must be mixed in 5% Dextrose (D5W) - NOT normal saline (precipitates)
- Preferably administered via a central line (peripheral use causes phlebitis)
- Can cause bradycardia and hypotension - slow the rate or give IV fluids if hypotension occurs
- Dose adjustment NOT required for renal failure; use caution in severe hepatic dysfunction
UK/European Practice (Alternative Protocol)
- Loading: 300 mg in 100 mL D5W over 20-30 minutes via central line
- Maintenance: 900 mg in 500 mL D5W over 24 hours at 21 mL/hour
Sources: Braunwald's Heart Disease (textbook); Tintinalli's Emergency Medicine (textbook); StatPearls - Amiodarone; Drugs.com Amiodarone Dosage
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