nexterone

Nexterone (amiodarone) is an antiarrhythmic medication that affects the rhythm of heartbeats.

Nexterone injection is used to help keep the heart beating normally in people with life-threatening heart rhythm disorders of the ventricles (the lower chambers of the heart that allow blood to flow out of the heart). Amiodarone is used to treat or prevent ventricular tachycardia or ventricular fibrillation.

Nexterone is for use only in life-threatening situations.

Important information

Nexterone injection is for use only in life-threatening situations. You will receive this medicine in a hospital setting.

You should not receive Nexterone injection if you are allergic to amiodarone or iodine, or if you have a serious heart condition such as "AV block" (unless you have a pacemaker), a history of slow heart beats, or if your heart cannot pump blood properly.

Before taking this medicine

You should not receive Nexterone if you are allergic to amiodarone or iodine, or if you have:

• certain serious heart conditions, especially "AV block" (unless you have a pacemaker); or

• a history of slow heart beats that have caused you to faint.

If possible before you receive Nexterone injection, tell your doctor if you have:

• breathing problems or lung disorder;

• liver disease;

• vision problems;

• high or low blood pressure;

• a thyroid disorder;

• an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);

• if you have recently been ill with vomiting or diarrhea;

• if your heart rhythm disorder has recently become worse; or

• if you have a pacemaker or defibrillator implanted in your chest.

In an emergency situation it may not be possible to tell your caregivers about your health conditions. Make sure any doctor caring for you afterward knows you have received this Nexterone.

FDA pregnancy category D. Do not use Nexterone if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.

See also: Pregnancy and breastfeeding warnings (in more detail)

Amiodarone can pass into breast milk and may harm a nursing baby. You should not breast-feed while receiving this medication.

In an emergency situation, it may not be possible before you are treated with Nexterone injection to tell your caregivers if you are pregnant or breast-feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received this medication.

How is Nexterone injection given?

Nexterone is injected into a vein through an IV. Nexterone injection is often given directly into a large vein in the upper chest (central IV line). You will receive this injection in a clinic or hospital setting where your heart can be monitored in case the medicine causes serious side effects.

To be sure Nexterone is not causing harmful effects, your blood will need to be tested often. Your thyroid and liver function may also need to be tested, and you may need eye exams and chest x-rays.

If you need surgery (including laser eye surgery), tell the surgeon ahead of time that you have received Nexterone injection.

This medicine can cause unusual results with certain thyroid tests, even after you stop using it. Tell any doctor who treats you that you have received Nexterone injection.

After treatment with Nexterone injection, your doctor may switch you to a tablet form of this medication. Be sure to read the medication guide or patient instructions for amiodarone oral.

What happens if I miss a dose?

Because you will receive Nexterone in a clinical setting, you are not likely to miss a dose.

What happens if I overdose?

Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid while using Nexterone injection?

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Grapefruit and grapefruit juice may interact with amiodarone and lead to unwanted side effects. Avoid the use of grapefruit products while you are receiving Nexterone.

Avoid exposure to sunlight or tanning beds. Amiodarone can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Nexterone side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Nexterone: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Amiodarone takes a long time to completely clear from your body. You may continue to have side effects from amiodarone after you stop using it. It could take up to several months for the medicine to completely clear from your body.

Call your doctor at once if you have any of these side effects, even if they occur up to several months after you stop using Nexterone:

• a new or a worsening irregular heartbeat pattern;

• fast, slow, or pounding heartbeats;

• a light-headed feeling, like you might pass out;

• wheezing, cough, chest pain, trouble breathing, coughing up blood;

• shortness of breath (even with mild exertion), swelling, rapid weight gain;

• blurred vision, vision loss, headache or pain behind your eyes, sometimes with vomiting;

• swelling, pain, redness, or irritation around your IV needle;

• weight loss, thinning hair, feeling too hot or too cold, increased sweating, irregular menstrual periods, swelling in your neck (goiter);

• pain in your upper stomach, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

• little or no urinating.

Common Nexterone side effects may include:

• low fever;

• slight dizziness; or

• mild nausea, vomiting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Nexterone?

Many drugs can interact with amiodarone. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with Nexterone, especially:

• an antibiotic - azithromycin, ciprofloxacin, clarithromycin, erythromycin, levofloxacin, moxifloxacin, pentamidine, and others;

• an antidepressant - amitriptyline, citalopram, desipramine, doxepin, imipramine, maprotiline, nortriptyline, and others;

• cancer medicines;

• a diuretic or "water pill";

• heart rhythm medication - dofetilide, dronedarone, ibutilide, propafenone, sotalol;

• HIV or AIDS medication - indinavir, nelfinavir, rilpivirine, ritonavir, saquinavir; OR

• medicine to treat mental illness - chlorpromazine, fluphenazine, haloperidol, lithium, pimozide, promethazine, thioridazine, ziprasidone, and others.

This list is not complete and many other drugs can interact with amiodarone. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Amiodarone takes a long time to completely clear from your body, and drug interactions are possible for up to several months after you stop using Nexterone injection. Talk to your doctor before taking any medication during this time. Keep track of how long it has been since your last dose.