Nexterone Dosage

Generic name: AMIODARONE HYDROCHLORIDE 1.5mg in 1mL
Dosage form: injection, solution
Drug class: Group III antiarrhythmics

Medically reviewed by Drugs.com. Last updated on Aug 28, 2023.

General Considerations

Inspect parenteral drug products for particulate matter and discoloration prior to administration, whenever solution and container permit, solution should be clear. Visually inspect the container. If the administration port protector is damaged, detached or not present, discard the container as the solution path sterility may be compromised. Check for minute leaks prior to use by squeezing the bag firmly. If leaks are detected, discard solution as sterility may be impaired. Protect from light until ready to use.

NEXTERONE Premixed Injection is available in GALAXY containers as a single-use, ready-to-use, iso-osmotic solution in dextrose for intravenous administration. No further dilution is required. Discard any unused portion after use.

Administer NEXTERONE, whenever possible, through a central venous catheter dedicated to that purpose. Use an in-line filter during administration.

Recommended Dosage

NEXTERONE response can vary. Monitor patient response and adjust dose accordingly. In controlled clinical trials, mean daily doses above 2100 mg were associated with an increased risk of hypotension.

Table 1: NEXTERONE Dosage Recommendations
Loading Infusion	First Rapid	150 mg over the FIRST 10 minutes (15 mg/min). Directly infuse NEXTERONE Premixed Injection (150 mg/100 mL; 1.5 mg/mL) at a rate of 10 mL/min.
	Followed by Slow	360 mg over the NEXT 6 hours (1 mg/min). Directly infuse NEXTERONE Premixed Injection (360 mg/200 mL; 1.8 mg/mL) at a rate of 0.556 mL/min. 540 mg over the REMAINING 18 hours (0.5 mg/min) Decrease the rate to 0.278 mL/min.
Maintenance Infusion		After the first 24 hours, continue the maintenance infusion 720 mg per 24 hour period (0.5 mg/min) Directly infuse NEXTERONE Premixed Injection (360 mg/200 mL; 1.8 mg/mL) at a rate of 0.278 mL/min).
Breakthrough VF or Hemodynamically Unstable VT		150 mg supplemental infusion over 10 minutes (15 mg/min). Directly infuse NEXTERONE Premixed Injection (150 mg/100mL; 1.5 mg/mL) at a rate of 10 mL/min.

Admixture Incompatibility
Amiodarone in D5W Injection forms precipitates with the drugs shown in Table 2. If co-administration of the following drugs is necessary, use separate intravenous administration lines.

Table 2: Y-SITE INJECTION INCOMPATIBILITY
D5W = Dextrose 5% in Sterile Water, NS = Normal Saline
Drug	Vehicle	Amiodarone Concentration
Aminophylline	D5W; NS	4 mg/mL
Amoxicillin Sodium-Clavulanic Acid	unknown	12.5 mg/mL
Ampicillin Sodium-Sulbactam Sodium	NS	6 mg/mL
Argatroban	D5W	1.8 mg/mL
Bivalirudin	D5W	4 mg/mL
Cefamandole Nafate	D5W	4 mg/mL
Cefazolin Sodium	D5W	4 mg/mL
Ceftazidime	D5W	6 mg/mL
Digoxin	D5W	6 mg/mL
Furosemide (10 mg/mL)	D5W	6 mg/mL
Mezlocillin Sodium	D5W	4 mg/mL
Heparin Sodium	D5W	--
Imipenem-Cilastin Sodium	D5W	6 mg/mL
Magnesium Sulfate (500 mg/mL)	D5W	6 mg/mL
Micafungin	NS	4 mg/mL
Piperacillin Sodium –Tazobactam Sodium	D5W	6 mg/mL
Potassium Phosphates	D5W	6 mg/mL
Sodium Bicarbonate	D5W	3 mg/mL
Sodium Nitroprusside	D5W	1.5, 6 and 15 mg/mL
Sodium Phosphates	D5W	6 mg/mL

Transition From Intravenous Amiodarone to Oral Amiodarone

Table 3 provides suggested doses of oral amiodarone to be initiated after varying durations of NEXTERONE infusion.

Table 3: RECOMMENDATIONS FOR ORAL DOSAGE AFTER INTRAVENOUS INFUSION
* Assuming a 720 mg/day infusion (0.5 mg/min). † Intravenous amiodarone is not intended for maintenance treatment.
Duration of Amiodarone Infusion*	Initial Daily Dose of Oral Amiodarone
Less than 1 week	800 to 1600 mg
1 to 3 weeks	600 to 800 mg
More than 3 weeks†	400 mg