Amiodarone (Cordarone, Pacerone) and Ketamine Therapy | Tovani Health
Cordarone (Amiodarone) (also: Pacerone) — Class III antiarrhythmic (potent CYP3A4 + CYP2D6 inhibitor; iodine-rich)
Verdict at Tovani Health
Long half-life and strong CYP inhibition make individual planning essential, even months after stopping.
Amiodarone alongside ketamine requires individual evaluation. Two unique features matter: the half-life is approximately 58 days (one of the longest of any drug in clinical use), so amiodarone remains active for months after the last dose; and amiodarone is a strong CYP3A4 and CYP2D6 inhibitor that meaningfully raises ketamine plasma exposure. Layered on top is the drug's intrinsic complexity — pulmonary, hepatic, thyroid, ophthalmic, and neurologic toxicities require ongoing monitoring independent of KAP.
If you take Cordarone regularly and are considering at-home ketamine therapy, the combination is depends on your specific situation. This page covers the brief pharmacologic context and what we do at intake.
How Cordarone interacts with ketamine
Amiodarone has class I, II, III, and IV antiarrhythmic activity (broad mechanism). Strong CYP3A4 and CYP2D6 inhibition. Iodine content (~37% by weight) contributes to its thyroid effects. Major QT prolongation but per the published ketamine literature ketamine does not meaningfully add to QT at psychiatric doses; the QT here is amiodarone's own intrinsic profile.
What we do at intake
Disclose dose, indication, duration of therapy, and date of last dose if you have stopped. Bring recent LFTs, TFTs, and EKG. We coordinate session planning around your cardiology team and may adjust ketamine dose downward for the CYP inhibition.
Bottom line
Amiodarone alongside ketamine requires individual evaluation. Two unique features matter: the half-life is approximately 58 days (one of the longest of any drug in clinical use), so amiodarone remains active for months after the last dose; and amiodarone is a strong CYP3A4 and CYP2D6 inhibitor that meaningfully raises ketamine plasma exposure. Layered on top is the drug's intrinsic complexity — pulmonary, hepatic, thyroid, ophthalmic, and neurologic toxicities require ongoing monitoring independent of KAP.
Ready to find out if at-home ketamine fits your situation?
We’ll note that you’re on Cordarone (Amiodarone) at intake. The eligibility check takes 5 minutes and gives you an honest answer about whether at-home ketamine fits your specific situation.
FL and NJ residents only. Benjamin Soffer, DO — Tovani Health.
Sources
The verdict and clinical guidance on this page are based on the following peer-reviewed literature and FDA prescribing information.
- Ketamine: A Review of Clinical Pharmacokinetics and Pharmacodynamics in Anesthetic and Pain Therapy. Peltoniemi MA, Hagelberg NM, Olkkola KT, Saari TI. Clinical Pharmacokinetics. 2016. PMID: 27028535
Reviews CYP3A4 inhibitors affecting ketamine clearance; strong inhibitors meaningfully raise exposure.
Clinically reviewed
Reviewed by Benjamin Soffer, DO on May 19, 2026. Dr. Soffer is a board-certified physician (American Board of Internal Medicine) licensed in Florida and New Jersey, prescribing at-home ketamine therapy through Tovani Health.
This page is general information about how this medication interacts with at-home ketamine therapy at Tovani Health. It is not a substitute for medical advice from your prescribing physician about your specific situation. Always discuss medication changes with the doctor who prescribed them.