Multaq® Tablets for Atrial Fibrillation

Multaq® (dronedarone) is a prescription antiarrhythmic tablet for adults with non-permanent atrial fibrillation. This page outlines clinical use, safety, and access through CanadianInsulin so you can order from Canada with US delivery from Canada. Review Canadian pricing for Multaq 400 mg, including options if paying without insurance.

At CanadianInsulin, orders are filled by licensed Canadian pharmacies after we confirm a valid prescription with your clinic.

What Multaq® Is and How It Works

Multaq® contains dronedarone, an antiarrhythmic medicine that helps regulate heart rhythm. It works on multiple cardiac ion channels and has antiadrenergic effects. In adults with a history of paroxysmal or persistent atrial fibrillation (AF) who are in sinus rhythm, it helps reduce the risk of AF-related hospitalizations. Multaq 400 mg tablets are usually taken with meals, which supports steady absorption.

Dronedarone HCl tablet 400 mg is not an anticoagulant. Many patients with AF also need a separate blood thinner for stroke prevention, but that decision is individualized by the prescriber. This page focuses on Multaq 400 mg uses aligned to official labeling and does not cover off-label therapy.

Who Multaq® Is For

Multaq is intended for adults with a history of paroxysmal or persistent AF who are currently in normal sinus rhythm or will be cardioverted to sinus rhythm. The goal is to reduce the likelihood of unplanned cardiovascular hospitalization related to atrial fibrillation.

Multaq is not for everyone. It is contraindicated in permanent AF. It should not be used in patients with symptomatic heart failure with recent decompensation, or in patients with NYHA Class IV heart failure. It is also contraindicated in people with severe liver impairment, second- or third-degree AV block or sick sinus syndrome without a pacemaker, a baseline QTc ≥ 500 ms, or a resting heart rate < 50 bpm. Strong CYP3A inhibitors and certain other interacting drugs are contraindicated. Patients with unstable electrolytes, especially low potassium or magnesium, need correction before therapy. Discuss pregnancy and breastfeeding with a clinician before starting.

Dosage and Usage

The usual Multaq dosage 400 mg is taken twice daily with meals, once with the morning meal and once with the evening meal. Swallow tablets whole with water. Do not take with grapefruit or grapefruit juice. Follow prescriber instructions about laboratory tests and ECG checks.

If cardioversion is planned, prescribers may adjust timing based on clinical status. This medicine is not a rescue treatment for sudden palpitations. Do not start, stop, or combine with other heart rhythm drugs unless a clinician directs it.

Strengths and Forms

Multaq is supplied as film-coated oral tablets containing 400 mg of dronedarone. Packaging and appearance may vary by manufacturer market. Availability can vary by dispensing pharmacy.

Missed Dose and Timing

If a dose is missed, take the next dose at the usual time. Do not double a dose to make up for a missed one. Keep doses spaced about 12 hours apart with meals to maintain a steady schedule. Using a medication reminder can help keep a consistent routine.

Storage and Travel Basics

Store tablets at room temperature, typically 20–25°C (68–77°F), in a dry place. Keep the bottle or blister pack tightly closed and protected from moisture. Do not store in a bathroom. Keep out of reach of children and pets.

For travel, keep Multaq in original labeled packaging. Use a carry-on bag to avoid temperature extremes. Pack enough tablets for the trip plus a small buffer. A simple pill organizer can help, but keep the label handy for security checks. If international travel is planned, carry a copy of the prescription and a medication list.

Benefits

When prescribed for appropriate patients, Multaq helps reduce the risk of cardiovascular hospitalization related to AF. The twice-daily tablet dosing may fit standard meal routines. No routine therapeutic drug-level monitoring is required. The medicine can be combined with anticoagulants or rate-control agents when a clinician deems it appropriate.

To explore related options for rhythm and rate control, see our Atrial Fibrillation category.

Side Effects and Safety

• Diarrhea
• Nausea or vomiting
• Abdominal pain or indigestion
• Fatigue or weakness
• Rash or itching
• Changes in kidney function tests
• Bradycardia (slow heart rate)

Serious effects are less common but need urgent attention. These include new or worsening heart failure, severe liver injury, marked bradycardia or conduction block, significant QT prolongation, lung inflammation, or severe skin reactions. Abnormal liver tests have been reported; prescribers may check liver enzymes before and during therapy. Stop the medicine and seek care promptly if symptoms such as shortness of breath, rapid weight gain, fainting, yellowing of skin or eyes, dark urine, or severe fatigue develop.

This medicine can cause rhythm changes that require ECG monitoring, especially early in treatment or after dose or medication changes. Report symptom changes to the care team.

Drug Interactions and Cautions

Important interactions include:

• Strong CYP3A inhibitors such as ketoconazole, itraconazole, clarithromycin, and certain antivirals. These are contraindicated.
• CYP3A inducers such as rifampin, carbamazepine, phenobarbital, phenytoin, and St. John’s wort. These can reduce effectiveness.
• Other QT-prolonging drugs and class I or class III antiarrhythmics. Combining may increase proarrhythmia risk.
• Rate-control agents such as beta blockers or certain calcium channel blockers. Dose adjustments may be needed to avoid bradycardia.
• Digoxin and certain statins (for example, simvastatin). Exposure can increase; prescribers adjust and monitor.
• Anticoagulants. Interaction patterns vary. Warfarin parameters may need closer checks when therapy changes. Direct oral anticoagulants may have exposure changes due to P-gp effects.
• Grapefruit or grapefruit juice. Avoid due to CYP3A inhibition.

Patients using stroke-prevention therapy may take a blood thinner alongside Multaq. Examples include Pradaxa® or Warfarin, selected by the prescriber based on stroke risk and kidney function. For broader context on DOAC safety, see Apixaban Side Effects and for vitamin K antagonists see Warfarin For Clots.

Do not change doses or add new medicines without consulting the care team. Prescribers may order baseline and follow-up ECGs, electrolytes, kidney tests, and liver tests.

What to Expect Over Time

Multaq is not a cure for AF, but it can help reduce AF-related hospitalizations in appropriate patients. Some people notice improved rhythm stability over time. Regular check-ins allow clinicians to assess response and safety with ECGs and labs. If AF becomes permanent or heart failure worsens, prescribers will reassess ongoing therapy.

Compare With Alternatives

Management of atrial fibrillation usually combines two decisions: rhythm strategy and stroke prevention. Rhythm control may use antiarrhythmics such as dronedarone or others chosen by a specialist. Rate control can be an alternative or add-on in many patients. Beta blockers, such as Metoprolol, are common for rate control. For stroke prevention, direct oral anticoagulants like Eliquis® are frequently prescribed when appropriate. The best choice depends on clinical history, kidney function, bleeding risk, and ECG findings.

Catheter ablation is another pathway for some patients. Decisions are individualized by cardiology specialists.

Pricing and Access

CanadianInsulin lists the current Multaq 400 mg price so patients can compare options. Many customers ask about the price of Multaq 400 mg, Multaq 400 mg cost, or a Multaq 400 mg cash price. We show Canadian pricing with US shipping for clarity. Orders are shipped from Canada to the US with prompt, express shipping.

You can place your order online and track it by email. Checkout is encrypted. To review current offers, visit Promotions. For exact item availability, see the product page during checkout.

Availability and Substitutions

Availability can vary by dispensing pharmacy and market conditions. If the requested item is unavailable, a prescriber may recommend a clinically appropriate alternative or a temporary adjustment. Pharmacy teams will not substitute without prescriber approval.

Patient Suitability and Cost Saving Tips

Good candidates include adults with paroxysmal or persistent AF who are in sinus rhythm and have no contraindications. Multaq is not suitable for patients with permanent AF or those with advanced or recently decompensated heart failure. People with significant conduction disease without a pacemaker, severe liver disease, or marked QT prolongation should not use it. Baseline ECG and laboratory testing guide safe use.

Cost-saving ideas include requesting a multi-month supply when appropriate, aligning refills with other chronic medicines, and using reminder tools so refills are ordered on time. Keep tablets in original packaging for insurance or travel, and bring documentation if crossing borders. Discuss any planned medication changes with the care team to avoid avoidable costs from therapy overlaps.

Questions to Ask Your Clinician

• Is Multaq appropriate for my type of atrial fibrillation?
• How will my ECG and lab tests be monitored during treatment?
• Do I also need an anticoagulant for stroke prevention?
• Which medicines or supplements should I stop before starting dronedarone?
• What signs of heart failure or liver injury should prompt urgent care?
• How long should therapy continue if my rhythm remains stable?
• What steps can reduce side effects while maintaining effectiveness?

Authoritative Sources

• Sanofi Multaq Prescribing Information
• Official Multaq Patient Site
• FDA DailyMed: Multaq

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