Multaq (Dronedarone) – Oral

What Is Multaq?

Multaq (dronedarone) is a heart medicine used to treat atrial fibrillation (also called AFib, a condition causing irregular and usually very rapid heart rhythm patterns). People with atrial fibrillation use Multaq to lower the risk of going to the hospital. This medicine is available as prescription tablets with only one strength (400 milligrams).

Multaq works by blocking passages through which charged potassium particles move in and out of the heart. Too many charged particles can cause atrial fibrillation and an increase in heart rate. Dronedarone helps to maintain a normal heart rhythm in people with atrial fibrillation.

What Is Multaq Used For?

Multaq is used in adults with AFib to control and maintain a normal heart rhythm. It also lowers the chance of this population needing to go to the hospital.

How to Take Multaq 

Take one tablet by mouth twice daily with meals (e.g., one tablet with a morning meal and one with an evening meal). Do not take this drug with grapefruit or grapefruit juice. Keep taking your prescribed dose even if you feel better. Always take your medicine as directed by your healthcare provider.

Storage

Store Multaq in a dry place at room temperature (77 degrees Fahrenheit). Do not store your drug in the bathroom. Keep all your medicines away from the reach of children and pets.

Toss any unused or expired drugs. Do not throw your medicine down the drain or flush it down the toilet. Contact your pharmacist if you have questions about the best way to discard unused or expired medicine.

What Are the Side Effects of Multaq?

The follwoing is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other symptoms or events, contact your pharmacist or a healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Some common side effects of Multaq include but are not limited to:

• Feeling weak or tired
• Nausea
• Vomiting
• Stomach pain
• Diarrhea
• Indigestion
• Skin problems (such as redness, rash, and itchy skin)

Talk to your healthcare provider if you have any of these symptoms, especially if they bother you or do not disappear.

Severe Side Effects

If you have serious side effects, please call your doctor immediately. If it is a medical emergency or life-threatening, call 911. Serious side effects of Multaq include the following:

• Acute liver failure (needing transplant), which can be indicated by a loss of appetite, nausea, vomiting, fever, malaise (general feeling of not being well), itching, jaundice (yellowing of the skin or whites of the eyes), dark urine, and pain in the upper stomach area
• Heart failure (worsening or new), which can include shortness of breath, wheezing, chest tightness, breathing problems that wake you up at night, gaining 5 pounds quickly, swollen legs or feet
• Heartbeat that is slow, unusual, or fluttering (atrial flutter)
• Dizziness 
• Anaphylaxis (life-threatening allergic reaction)
• Angioedema (swelling under the skin)
• Pulmonary fibrosis (lung tissue that's damaged and scarred)
• Skin photosensitivity (sensitivity to ultraviolet light, including from the sun)
• Vasculitis (inflammation of the blood vessels)
• Kidney problems

Dosage: How Much Multaq Should I Take?

Missed Dose

If you miss a dose of your drug, skip the missed dose. Start back at your regular time. Do not take extra doses or two doses at a time.

Overdose: What Happens If I Take Too Much Multaq?

Overdose symptoms may include:

• Trouble breathing
• Skin photosensitivity
• Angioedema
• Slow or abnormal heartbeat
• Muscle weakness
  

Precautions

What Are Reasons I Shouldn’t Take Multaq?

In some cases, Multaq may not be an appropriate medication for you.

You should not take Multaq if you:

• Are allergic to the medication or any of its ingredients
• Are pregnant
• Are breastfeeding
• Have a severe liver problem
• Have permanent atrial fibrillation
• Take drugs for QT prolongation (a condition in which the heart takes longer than normal to recharge between beats)
• Have had symptomatic heart failure within the last four weeks
• Had liver or lung toxicity when using a medication called amiodarone 
• Have bradycardia (heartbeat less than 60 beats per minute)

Multaq doubles the risk of death in people with heart failure. It also doubles the risk of stroke, hospitalization, and death in people with permanent atrial fibrillation.

What Other Medications Interact With Multaq?

If you are on Multaq, there are some medications you should avoid. Do not take Multaq with these drugs:

• Thorazine (chlorpromazine)
• Celexa (citalopram)
• Biaxin XL (clarithromycin)
• Gengraf (cyclosporine) 
• Silenor (doxepin)
• Adriamycin (doxorubicin)
• Relpax (eletriptan)
• Levaquin (levofloxacin)
• Avelox (moxifloxacin) 
• Seroquel (quetiapine)
• Nurtec (rimegepant)
• Saint-John's-wort
• Mellaril (thioridazine)
• Tricyclic antidepressants

What Medications Are Similar?

 Other medications that are used to treat arrhythmia, like Multaq, include:

• Digitek, Digox, Lanoxin (digoxin)
• Pacerone, Cordarone (amiodarone)
• Betapace, Sorine, Sotylize (sotalol)
• Tambocor (flecainide)

Digoxin is used to treat both heart failure and atrial fibrillation. It has no black box warning (the FDA's strictest warning), while Multaq has two such warnings. On the other hand, amiodarone has a more extensive list of serious side effect profiles than Multaq. Sotalol and flecainide are comparable to Multaq.

Above is a list of drugs also prescribed for atrial fibrillation. It is not a list of drugs recommended to take with Multaq. In fact, you should not take these drugs together. Ask your pharmacist or healthcare provider if you have any questions.

How Can I Stay Healthy While Taking Multaq?

Talk to your healthcare provider about all of the medications you take, including vitamins, supplements, and OTC products. Also, tell your provider about any current or new health conditions that you may have. Liver problems resulting in liver transplants have occurred with this drug. Hence, if you experience any new or worsening conditions, inform your healthcare team as soon as possible.

Do not take Multaq with grapefruit or grapefruit juice. Grapefruit juice increases the levels of the drug in your system, causing more harm to you.

If you are pregnant or you plan to become pregnant, let your provider know. This medicine can harm the fetus. You may need a different treatment.