What is the maximum total dose of amiodarone allowed in pediatric cardiac arrest?

• A. 15 mg/kg total
• B. 20 mg/kg total
• C. 10 mg/kg total
• D. 5 mg/kg total

Answer: (A)

In pediatric cardiac arrest, amiodarone is used after shock delivery attempts for persistent shockable rhythms. The dosing is weight-based and given as IV or IO boluses. The standard approach is 5 mg/kg per dose, and you may repeat it up to two more times if the rhythm remains unstable, for a total of three doses. There’s a per-dose limit of 300 mg, but the cumulative maximum is 15 mg/kg. This balance provides enough antiarrhythmic effect to help stabilize refractory VT/VF while limiting the risk of adverse effects from excessive dosing. Therefore, the maximum total dose is 15 mg/kg.