What is the initial dose of amiodarone given IV/IO?

• A. 50 mg IV/IO
• B. 100 mg IV/IO
• C. 150 mg IV/IO in 50 cc NS over 10 minutes
• D. 300 mg IV/IO

Answer: (C)

Amiodarone dosing depends on the patient's rhythm and stability. For a wide-complex tachycardia or VT with a pulse (a patient who is stable enough to receive a controlled infusion), the initial amiodarone dose is given as an infusion rather than a rapid bolus. Delivering 150 mg IV/IO over about 10 minutes (diluted in 50 mL of normal saline) provides enough time for the drug to work and minimizes the risk of acute hemodynamic instability that can come with a quick push. If needed, additional dosing or an eventual continuous infusion is guided by protocol and the patient’s response.

This is in contrast to the cardiac-arrest scenario (pulseless VT/VF), where a rapid 300 mg IV/IO bolus is typical, with a second 150 mg dose if ROSC is not achieved. The 150 mg over 10 minutes approach is specifically for stable tachyarrhythmias where a slower infusion is safer and effective.