Amiodarone maintenance dosing should be capped at 400 mg with serum concentrations kept below 2.5 mg/L to optimize the benefit-to-risk ratio.
Hypothesis-generating for amiodarone dose optimization; prospective trials needed before clinical adoption.
The purpose of the present report is to review the available pharmacokinetic information on amiodarone with an emphasis on our own experience in monitoring serum amiodarone concentrations. We have found that 400 mg should be the maximal maintenance dose; if that treatment fails, careful addition of other antiarrhythmic agents is preferable over an increase in amiodarone dosage. Serum concentrations below 2.5 mg/L will significantly improve amiodarone's benefit-to-risk ratio.
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Rotmensch et al. (1983) studied this question.
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