provider image
Welcome! You’re in GoodRx for healthcare professionals. Now, you’ll enjoy a streamlined experience created specifically for healthcare professionals.
Skip to main content

Nexterone

amiodarone
Used for Ventricular Arrhythmia
Used for Ventricular Arrhythmia

Amiodarone solution (Nexterone) is an antiarrhythmic medication. It's used to stabilize serious and life-threatening heart rhythm problems, like ventricular fibrillation (VF) and ventricular tachycardia (VT), when other treatment options haven't worked well. Amiodarone solution comes in premixed (brand name Nexterone) or concentrate formulations for infusion. It's given intravenously (IV) in a hospital setting under the supervision of a cardiology team. Common side effects of the infusion include low blood pressure, nausea, and slow heart rate.

Once the heart rhythm stabilizes, the cardiology team might transition you to amiodarone oral tablets (Pacerone).

Reviewed by:
reviewer
Connie Zheng, PharmD
reviewer
Kristianne Hannemann, PharmD
Last reviewed on January 15, 2025
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsContraindicationsAlternativesReferencesPricesMedicare
basics-icon

What is Amiodarone (Nexterone)?

What is Amiodarone (Nexterone) used for?

How Amiodarone (Nexterone) works

Amiodarone (Nexterone) is a class III antiarrhythmic medication. It mainly works by blocking potassium channels in the heart. This slows down the electrical activity in the heart and stabilizes heart rhythm.

Are you looking for information on amiodarone tablets (Pacerone) instead?

Drug Facts

Common BrandsNexterone
Drug ClassAntiarrhythmic
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
basics-icon

What are the side effects of Amiodarone (Nexterone)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Other Side Effects

  • Injection site reactions (e.g., pain, redness, swelling)
  • Fever
  • Heart failure
  • Diarrhea
  • Breathing problems
  • Vomiting

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Dangerously low blood pressure: dizziness, lightheadedness, headache, confusion, blurry vision, nausea, vomiting, fast heart beat
  • Lung damage: cough, trouble breathing, chest pain or tightness, wheezing, fever
  • Serious heart problems: dizziness, fainting, chest pain, trouble catching your breath, tiredness, nausea, irregular heartbeat
  • Serious liver problems: fever, chills, tiredness, vomiting, diarrhea, stomach pain, swollen belly, clay-colored stool, itchy skin, yellowing of the skin or whites of the eyes
  • Thyrotoxicosis (dangerously high thyroid hormone level): diarrhea, shaking, tremors, agitation, anxiety, feeling hot
  • Serious skin reactions: rash, blisters, peeling skin, flu-like symptoms

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Blurred vision

confusion

dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly

sweating

unusual tiredness or weakness

Less common

Black, tarry stools

bleeding gums

blistering, peeling, or loosening of the skin

blood in the urine or stools

chest pain or discomfort

chills

cold, clammy skin

cough

decreased urine output

diarrhea

difficulty with breathing

dilated neck veins

dizziness

extreme fatigue

fainting

fast, pounding, or irregular heartbeat or pulse

fast, weak pulse

fever

irregular heartbeat recurrent

itching

joint or muscle pain

lightheadedness, dizziness, or fainting

no blood pressure or pulse

pinpoint red spots on the skin

red, irritated eyes

red skin lesions, often with a purple center

shortness of breath

slow or irregular heartbeat

sore throat

sores, ulcers, or white spots in the mouth or on the lips

stopping of the heart

swelling of the face, fingers, feet, or lower legs

tightness in the chest

troubled breathing

unconsciousness

unusual bleeding or bruising

weight gain

wheezing

Incidence not known

Abdominal or stomach pain

agitation

back, leg, or stomach pains

bleeding gums

bloating

blurred or double vision

clay-colored stools

coma

confusion about identity, place, and time

cough or hoarseness

coughing or spitting up blood

cracks in the skin

dark-colored urine

decreased frequency or amount of urine

decreased urine output

depression

difficulty swallowing

eye pain

fever with or without chills

general body swelling

general feeling of tiredness or weakness

headache

high fever

hives

holding false beliefs that cannot be changed by fact

hostility

increased blood pressure

increased thirst

indigestion

inflamed tissue from infection

irritability

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

lethargy

light-colored stools

loss of appetite

loss of heat from the body

lower back or side pain

muscle cramps or spasms

muscle pain or stiffness

muscle twitching

muscular pain, tenderness, wasting, or weakness

noisy breathing

nosebleeds

painful or difficult urination

pains in the stomach, side, or abdomen, possibly radiating to the back

pale skin

persistent non-healing sore

pink growth

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

rapid weight gain

rash

red, swollen skin

reddish patch or irritated area

redness, soreness, or itching skin

scaly skin

seeing, hearing, or feeling things that are not there

seizures

severe headache

shiny bump

sores, welting, or blisters

stupor

swollen or painful glands

unexplained bleeding or bruising

unpleasant breath odor

unusual excitement, nervousness, or restlessness

upper right abdominal pain

vomiting

vomiting of blood

weakness

white, yellow, or waxy scar-like area

yellow eyes and skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Amiodarone (Nexterone)

thumbs-up

Pros

IV amiodarone can start to work more quickly than amiodarone oral tablets

Option for VF and VT when other medications haven't worked well

Some side effects, like low blood pressure, can get better with a slower infusion rate

thumbs-down

Cons

Not for people with iodine allergy

Infused through the veins, not good for people who don't like needles

Not a good option for people who are pregnant

pharmacist-tips

Pharmacist tips for Amiodarone (Nexterone)

pharmacist

  • Some people experience low blood pressure, typically within hours, of starting amiodarone (Nexterone) infusion. This side effect is likely related to the infusion rate. Let your cardiology team know if you notice symptoms of low blood pressure, such as dizziness or feeling weak. They can slow down the infusion rate to help.

    • Typically, people receive amiodarone (Nexterone) infusion for 2-3 weeks, until their condition becomes stable and they're able to take medications by mouth. After that, your cardiologist might transition you to the amiodarone oral tablet (Pacerone). If you're not sure, talk with your care team about next steps.

      • If you and your cardiologist decide to stop amiodarone (Nexterone), this medication can still last in the body for many weeks. This means that you're still at risk for side effects and medication interactions for weeks after your dose.

        • Avoid grapefruit or grapefruit juice while taking amiodarone (Nexterone) because it can raise the amount of the medication in your body, which raises your risk of side effects.

          • Don't take amiodarone (Nexterone) during pregnancy because it can cause harm to growing babies. Let your healthcare team know if you're pregnant or want to become pregnant and they can let you know about safer treatment options.

            faqs

            Frequently asked questions about Amiodarone (Nexterone)

            How long does it take for amiodarone (Nexterone) to work?
            It can take a few days to weeks for amiodarone (Nexterone) to stabilize your heart rhythm. Your cardiologist will prescribe a higher loading dose during the first 24 hours so the medication can build up in your system. After that, they'll continue amiodarone (Nexterone) infusion with a lower maintenance dose. You might stay on the infusion for 2 to 3 weeks. Once your heart rhythm becomes stable and you're able to take medications by mouth, your cardiologist will likely replace amiodarone (Nexterone) infusion with amiodarone oral tablets (Pacerone).
            Does amiodarone (Nexterone) lower blood pressure?
            Yes, people who receive amiodarone (Nexterone) infusion commonly experience low blood pressure, especially during the first few hours after starting treatment. But this side effect is likely related to the infusion rate, rather than the medication itself. If your blood pressure starts to drop, your cardiology team can slow down the infusion. If needed, they'll give you medications to bring your blood pressure back up. Rarely, blood pressure can drop dangerously low and won't respond well to treatments. In this case, your cardiologist might ask you to stop amiodarone (Nexterone). Let your care team know if you feel symptoms of low blood pressure, such as dizziness or weakness, after you start the infusion.
            Does amiodarone (Nexterone) lower heart rate?
            Amiodarone (Nexterone) can lower heart rate because it slows the electrical activity of the heart. This medication is FDA approved to treat fast heart rate (tachycardia). But sometimes, it can cause your heart rate to become too slow (bradycardia). Let your cardiologist know if you notice symptoms of very slow heart rate, like dizziness, tiredness, or chest pain.
            Is amiodarone (Nexterone) a beta blocker?
            Amiodarone (Nexterone) is a class III antiarrhythmic, not a beta blocker. Both amiodarone (Nexterone) and beta blockers can help with arrhythmia and lower heart rate, but they do so in different ways. Talk with your cardiologist if you have more questions about how amiodarone (Nexterone) works.
            What are some serious side effects of amiodarone (Nexterone)?
            Amiodarone (Nexterone) can cause some rare but serious side effects. One example is lung toxicity. Symptoms include coughing or trouble breathing, and can appear within days to weeks after the start of treatment. Another example is liver problems. Most of the time, you can see signs of liver irritation only through blood tests. But rarely, you might feel symptoms of liver problems, like a swollen belly or nausea. To lower the risk of complications from amiodarone side effects, your cardiology team will likely order tests to check your lungs, liver, heart, and other parts of the body, before you start treatment. They'll continue to monitor you closely during your amiodarone (Nexterone) infusion. If needed, they might lower your dose of amiodarone (Nexterone) or ask you to stop taking this medication.
            Can you take amiodarone (Nexterone) for atrial fibrillation?
            Amiodarone (Nexterone) isn't FDA-approved for atrial fibrillation (AFib), a type of heart rhythm problem. But amiodarone (Nexterone) is sometimes prescribed by cardiologists off-label for this condition. And once your condition is more stabilized, your care team will likely transition you from amiodarone infusion to oral amiodarone tablets. Talk with your healthcare team if you have more questions on amiodarone (Nexterone) and AFib.
            Does amiodarone (Nexterone) come in pill form?
            Yes, amiodarone (Pacerone) is available as an oral pill. If you have a life-threatening heart rhythm condition, you cardiology team might try to stabilize your heart with amiodarone (Nexterone) infusion first. Once your condition is stable and you're able to take medications by mouth, your care team will ask you to switch from amiodarone infusion to amiodarone oral tablets.
            GoodRxEducationalIcon

            How to save using GoodRx

            Compare Prices
            1. Compare PricesSpecify your dosage and quantity to find out exactly how much you can save.
            Select your free coupon
            2. Select your free couponYou can use the displayed coupon, or compare prices at other pharmacies near you.
            Show coupon to your pharmacist
            3. Show coupon to your pharmacistPresent your printed or electronic coupon when you pick up your prescription.
            Get free couponLearn more
            warings-icon

            What are the risks and warnings for Amiodarone (Nexterone)?

            Amiodarone (Nexterone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

            risk-warning

            Low blood pressure

            • Risk factors: Fast infusion rate

              Hypotension (low blood pressure) is a common side effect of amiodarone (Nexterone) infusions. It typically occurs within the few hours of treatment. Low blood pressure is more likely related to how quickly the medication is infused, and not the medication itself. Let your cardiology team know if you notice symptoms of low blood pressure, such as dizziness or weakness. If needed, your team can slow down the amiodarone (Nexterone) infusion or give you other medications and treatments to bring your blood pressure back up. Or, they might ask you to stop amiodarone (Nexterone) and consider other options. Rarely, low blood pressure can be life-threatening and difficult treat.

              risk-warning

              Slow heart rate and heart block

              Though rare, amiodarone (Nexterone) can cause slow heart rate and heart block. Your cardiology team will monitor you closely for these conditions and slow down or stop the infusion if needed. Some people might need a temporary pacemaker to help with heart block.

              risk-warning

              Worsening heart rhythm problems

              • Risk factors: Taking water pills or laxatives | Electrolyte levels that are out of balance | Diarrhea

                Sometimes, taking amiodarone (Nexterone) can worsen heart rhythm problems, which can be life-threatening. Before you start treatment, your cardiology team will check that your fluid and electrolyte levels are within a safe range, especially if you recently lost a lot of fluids.

                risk-warning

                Serious liver problems

                Amiodarone (Nexterone) can cause serious liver problems. People who have life-threatening VT or VF will also show signs of liver irritation on their liver enzyme tests. So if you're taking amiodarone (Nexterone), it might be difficult for the cardiology team to know if the abnormal liver enzyme tests are caused by the heart condition or a side effect of the medication. To be safe, they'll monitor you closely for liver problems. If needed, they'll slow down the rate of amiodarone (Nexterone) infusion or ask you to stop this medication. Tell you medical team right away if you notice symptoms of liver problems, such as stomach pain, swollen belly, or yellowing of the skin or whites of the eyes.

                risk-warning

                Lung injury and serious lung problems

                Though rare, people who have received amiodarone (Nexterone) infusions have reported lung injuries days to weeks after their treatment. Let your healthcare team know if you have symptoms of lung problems, like wheezing, cough, or fever.

                If you're expected to continue amiodarone treatment with oral tablets, your cardiology team will order a chest X-ray before you start treatment and check your lung health regularly throughout treatment. Rarely, people who have received amiodarone have experienced life-threatening lung problems.

                risk-warning

                Vision problems

                Though rare, people who took amiodarone (Nexterone) have experienced vision problems, including permanent blindness. This can happen at any time during treatment. Let your cardiology team know right away if you notice a change in your vision, including blurriness or trouble seeing things to the side.

                If you're continuing with oral amiodarone, your care team might ask you to get regular eye exams during treatment. Also, tell your optometrist or eye specialist if you're taking amiodarone because you'll need to avoid certain eye procedures, like corneal refractive laser surgery.

                risk-warning

                Thyroid problems

                • Risk factors: Not taking enough dietary iodine | Past thyroid problems

                  Amiodarone can affect your thyroid hormone levels and cause either low or high levels hormone levels. Your prescriber will check your thyroid function tests regularly throughout treatment with amiodarone (Nexterone), and if you're continuing with oral amiodarone.

                  High thyroid levels (hyperthyroidism) can cause an arrhythmia, which can be dangerous. Let your care team know right away if you notice symptoms of thyroid problems, including weight changes, mood changes, sweating more than usual, and dry or discolored skin.

                  risk-warning

                  Harm to unborn babies

                  Amiodarone (Nexterone) can cause harm to unborn babies if taken by mothers during pregnancy. If you're able to become pregnant, your healthcare team might ask you to take a pregnancy test to confirm you're not pregnant before you can start amiodarone (Nexterone), especially if you're continuing with oral amiodarone. You're recommended to use effective birth control during treatment with amiodarone.

                  risk-warning

                  Severe allergic and skin reactions

                  Although rare, amiodarone (Nexterone) can cause serious allergic reactions that can sometimes be life-threatening. Tell your care team right away if you experience signs of an allergic reaction, such as trouble breathing, rash, fast heartbeat, sweating, blisters, or peeling skin.

                  dosage

                  Amiodarone (Nexterone) dosage forms

                  Typical dosing for Amiodarone (Nexterone)

                  Amiodarone (Nexterone) comes as concentrate solution in vials and a pre-mixed injection (brand name Nexterone).

                  • Loading dose: The typical loading dose is about 1,000 mg infused over the first 24 hours. Usually, the cardiology team will give 150 mg as a rapid infusion over the first 10 minutes, then give 360 mg more slowly over the next 6 hours. After that, they'll give the rest of the loading dose (540 mg) even more slowly, over the remaining 18 hours.

                  • Maintenance dose: After the first 24 hours, the typical maintenance dose is 720 mg infused slowly every 24 hours, usually for 2 to 3 weeks. The cardiology team will typically give an additional 150 mg over 10 minutes to stabilize any breakthrough arrhythmias.

                  Once the heart rhythm stabilizes and you're able to take medication by mouth, the team will transition you to amiodarone oral tablets (Pacerone).

                  interactions

                  Interactions between Amiodarone (Nexterone) and other drugs

                  Amiodarone (Nexterone) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Amiodarone (Nexterone). Please note that only the generic name of each medication is listed below.

                  Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

                  Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                  Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                  Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                  contraindications-icon

                  Amiodarone (Nexterone) contraindications

                  Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Amiodarone (Nexterone) will not be safe for you to take.
                  alternatives

                  What are alternatives to Amiodarone (Nexterone)?

                  There are a number of medications that your doctor can prescribe in place of Amiodarone (Nexterone). Compare a few possible alternatives below.
                  Amiodarone (Nexterone)
                  Used for:
                  View Prices
                  Disopyramide (Norpace)
                  Used for:
                  $66.01 Lowest GoodRx priceView Prices
                  Mexiletine
                  Used for:
                  $38.94 Lowest GoodRx priceView Prices

                  Get savings updates for Amiodarone (Nexterone)

                  Receive price alerts, news, and other messages from GoodRx about Amiodarone (Nexterone) and other healthcare topics and relevant savings offers.

                  By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx.

                  References

                  Best studies we found

                  American Heart Association. (2024). Medications for arrhythmia.

                  American Heart Association. (2024). Tachycardia: Fast heart rate.

                  American Heart Association. (2024). Ventricular fibrillation.

                  View All References (11)

                  Baxter Healthcare Corporation. (2025). Nexterone- amiodarone hydrochloride injection, solution [package insert]. DailyMed.

                  Connolly, S. J. (1999). Evidence-based analysis of amiodarone efficacy and safety. Circulation.

                  Florek, J. B., et al. (2023). Amiodarone. StatPearls.

                  Frenesius Kabi USA, LLC. (2023). Amiodarone hydrochloride- amiodarone hydrochloride injection, solution [package insert]. DailyMed.

                  Hainan Poly Pharm. Co., Ltd. (2024). Amiodarone hydrochloride injection, solution [package insert]. DailyMed.

                  MedlinePlus. (2024). Sick sinus syndrome.

                  MedlinePlus. (2024). Ventricular tachycardia.

                  National Heart, Lung, and Blood Institute. (2022). Conduction disorders.

                  National Heart, Lung, and Blood Institute. (2022). What is cardiogenic shock?

                  Siddoway, L. A. (2003). Amiodarone: Guidelines for use and monitoring. American Family Physician.

                  Turbert, D. (2023). What is refractive surgery? American Academy of Ophthalmology.

                  GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
                  Was this page helpful?

                  Compare other Ventricular Arrhythmia drugs

                  Betapace vs NexteroneBetapace vs CordaroneBetapace vs LopressorBetapace vs Quinidine SulfateBetapace vs Tenormin
                  View More

                  Browse medications

                  View All

                  Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.