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Cin-Quin vs. Amiodarone

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Quinidine and Amiodarone (Pacerone) are both antiarrhythmic medications used to treat abnormal heart rhythms, but they have some key differences. Quinidine, available only in generic form, works by blocking sodium channels in the heart, while Amiodarone (Pacerone) blocks various receptors and channels. Quinidine is used for atrial fibrillation, flutter, and ventricular arrhythmias, but it is less commonly used today due to its many side effects and higher risk of death compared to alternatives. Amiodarone (Pacerone), available as both a brand and generic, is used for life-threatening ventricular arrhythmias and can take weeks to work. It must be started in the hospital and has several serious side effects, including lung and liver damage, and long-term effects like blue skin. Both medications require close monitoring, but Amiodarone (Pacerone) stays in the body for many weeks, making its side effects potentially long-lasting.

Quinidine

 

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Amiodarone

(Pacerone)

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Summary for Cin-Quin

Prescription only

Quinidine is one of the oldest antiarrhythmic medications, but isn't used as often these days since there are better alternatives.

Indications for Cin-Quin

  • Treatment of atrial fibrillation or flutter
  • Prevention of atrial fibrillation or flutter
  • Prevention of ventricular arrhythmias

Pros and Cons for Cin-Quin

Pros

  • A preferred choice for some people with Brugada syndrome
  • Available in a lower-cost, generic form

Cons

  • Higher chance of death compared to alternatives; only used in very specific scenarios
  • Many drug interactions

Common Side Effects for Cin-Quin

  • Diarrhea (35%)
  • Upset stomach (22%)
  • Lightheadedness (15%)
  • Headache (7%)
  • Fatigue (7%)
  • Palpitations (7%)
  • Chest pain (6%)
  • Weakness (5%)
  • Rash (5%)

Warnings for Cin-Quin

  • Higher risk of death
  • Arrhythmia (abnormal heart rhythm)
  • Quinidine levels too high/low
  • Drug interactions

Summary for Amiodarone

Prescription only

Amiodarone (Pacerone) is an antiarrhythmic medication. It's FDA-approved to treat life-threatening ventricular fibrillation and fast heart rate (tachycardia) in adults who either can't take it or whose condition isn't well-controlled by other antiarrhythmics. It's sometimes prescribed off-label for atrial fibrillation (AFib). Amiodarone (Pacerone) comes as tablets that are taken by mouth. The total daily dose can be taken once per day, or split into smaller doses and taken throughout the day to prevent stomach-related side effects, like nausea and vomiting.

Indications for Amiodarone

  • Life-threatening ventricular fibrillation that keeps coming back (when other antiarrhythmics haven't worked well)
  • Life-threatening tachycardia that keeps coming back (when other antiarrhythmics haven't worked)

Pros and Cons for Amiodarone

Pros

  • Works well to treat certain heart rate and rhythm problems
  • Can be taken with or without food
  • Can be taken once daily (as long as you're tolerating the medication and the total daily dose is less than 1,000 mg)

Cons

  • Stays in the body for many weeks
  • Not for people with iodine allergy
  • Only available as a 200 mg tablet, so you might need to take several tablets depending on your dose

Common Side Effects for Amiodarone

Warnings for Amiodarone

  • Arrhythmia (abnormal heartbeat)
  • Lung damage
  • Liver damage
  • Vision problems
  • Thyroid problems
  • Slow heartbeat
  • Effects on heart devices
  • Harm to unborn babies
  • Nerve problems

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