Dronedarone (Multaq)

How Medicare covers it

Part D (forms used at home). Part A during a covered inpatient stay. No Part B clinician-administered form in the CMS Part B spending file.

What it treats

Lowering the risk of hospitalization for atrial fibrillation (AF) in patients who are currently in normal (sinus) rhythm and have a history of paroxysmal or persistent AF.

What it is for, in depth

Dronedarone is prescribed for people in sinus rhythm who have had paroxysmal or persistent atrial fibrillation, to reduce the chance of being hospitalized for AF. Its place in the treatment path is tightly fenced by the boxed warning: it is only for people who can be kept in sinus rhythm, never for permanent AF, and never for people with recently decompensated or class IV heart failure. It comes as a single 400 mg tablet strength, taken twice daily with meals.

How it works

Dronedarone is a heart rhythm drug (antiarrhythmic) with properties from all four Vaughan-Williams classes. The label states that its exact mechanism of action is unknown.

How it is taken

One 400 mg tablet twice a day — one with the morning meal and one with the evening meal. Class I or III rhythm drugs and strong CYP3A inhibitors must be stopped before starting. Heart rhythm should be checked at least once every 3 months; if atrial fibrillation is found, the drug is stopped or the patient is cardioverted.

Common side effects

The label's adverse section focuses on its serious risks — new or worsening heart failure, liver injury, lung toxicity, low potassium and magnesium, and QT prolongation — rather than frequent minor effects.

Serious warnings

BOXED WARNING: in symptomatic heart failure with recent decompensation or NYHA Class IV heart failure, Multaq doubles the risk of death and is contraindicated; in permanent atrial fibrillation it doubles the risk of death, stroke, and heart failure hospitalization and is contraindicated. Other label warnings: liver injury (stop if suspected), lung toxicity (stop if confirmed), new or worsening heart failure, low potassium and magnesium (keep levels normal), kidney function monitoring, QT prolongation, and fetal harm — effective contraception is required for females who can become pregnant.

Boxed warning

In patients with symptomatic heart failure with recent decompensation requiring hospitalization, or NYHA Class IV heart failure, Multaq doubles the risk of death. Multaq is contraindicated in those patients. In patients with permanent atrial fibrillation, Multaq doubles the risk of death, stroke, and hospitalization for heart failure. Multaq is contraindicated in patients in atrial fibrillation who will not or cannot be cardioverted into normal sinus rhythm.

Who should be careful

The long contraindication list includes permanent AF, recently decompensated or class IV heart failure, second- or third-degree AV block or sick sinus syndrome without a pacemaker, heart rate under 50, QTc over 500 ms or PR over 280 ms, severe liver impairment, prior liver or lung toxicity from amiodarone, and allergy to the drug. Do not breastfeed while taking it.

Major interactions

Strong CYP3A inhibitors (ketoconazole, itraconazole, voriconazole, cyclosporine, telithromycin, clarithromycin, nefazodone, ritonavir), erythromycin, and QT-prolonging drugs are contraindicated with it; CYP3A inducers and grapefruit juice should be avoided. It interacts with digoxin (consider stopping it or halving the dose, and monitor levels), calcium channel blockers and beta-blockers (start low, check ECG), statins (do not exceed simvastatin 10 mg a day), narrow-range CYP3A drugs such as sirolimus and tacrolimus, and warfarin (monitor INR).

Cost and saving notes

Multaq is a brand-only tablet covered under Medicare Part D. If your plan's tier makes it hard to afford, you can ask your plan for a tier exception. If you qualify for Extra Help, the Part D low-income help, your drug costs will be much lower.

Why it is in its tier

Dronedarone (Multaq) sits on Tier 3 in 62.4% of the plans that list it (3119 of 4998 listing plans). Tier 3 is the preferred brand tier — mid-level copays or coinsurance. The data-visible drivers: It is a brand-only product with no generic version in the formulary data, and the CMS dashboard puts its average Part D spending at about $5,700 per beneficiary for 2024 — a high-cost drug, which matches where plans place it. It is listed by 90.96% of Part D plans. The tier shown is the most common one; individual plans vary.

Sources

• MULTAQ (DRONEDARONE) TABLET, FILM COATED [CARDINAL HEALTH 107, LLC] — DailyMed
• MedlinePlus — Dronedarone

What official patient guides say

Dronedarone comes as a tablet to take by mouth (the Multaq tablet form in this package). MedlinePlus says it is usually taken twice a day, with the morning meal and with the evening meal, at around the same times every day. Take it exactly as directed — do not take more or less of it or take it more often than your doctor prescribed. Your doctor may also prescribe other medicines to lower your risk of stroke while you are taking dronedarone; take those exactly as directed during your treatment. Dronedarone will help control your heartbeat only as long as you keep taking it. Keep taking it even if you feel well and have felt well for a long time, and do not stop taking it without talking to your doctor. If you forget a dose, skip the missed dose and go back to your regular schedule. Do not try to make up for a missed dose, and do not take a double dose. Keep the tablets in the container they came in, tightly closed and out of reach of children. Store them at room temperature, away from extra heat and moisture, and not in the bathroom. Do not flush leftover medicine. Ask your pharmacist about a medicine take-back program.

Source: MedlinePlus — Dronedarone

Part D formulary coverage

Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets resolved through the NLM RxNav (RxNorm) API.

What you pay

Without insurance, the cash benchmark is 13.18621 per unit (MULTAQ 400 MG TABLET) — about nan for 30 units. NADAC benchmark — the average price pharmacies pay (CMS, as of 2026-11-04). Pharmacy shelf prices vary.

A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.

Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-07

Coverage by plan and tier

Of the 5,495 Medicare drug plans we track for 2027, 4,998 list Dronedarone (Multaq) — 91.0% of plans. Most of those plans put it on Tier 3: 3,119 plans, 62.4% of the plans that list it. Other plans place it on Tier 4 (1,764 plans), Tier 1 (107 plans) or Tier 2 (8 plans). For example: Aetna Medicare Dual Extra (HMO D-SNP) puts it on Tier 4; Aetna Medicare Dual Extra Care (PPO D-SNP) puts it on Tier 4; Aetna Medicare Value Plus (PPO) puts it on Tier 4. You can compare these plans side by side on our Medicare Advantage hub. A tier is not a price. What you pay also depends on whether you have met your plan';s deductible, whether the drug costs a flat copay or a share of the price, and whether you get Extra Help or Medicaid.

Read next

• Part D in 2027: The $700 Deductible, the $2,400 Cap, and the $35 Insulin Rule
• Extra Help in 2027: Lower Drug Copays and Who Qualifies
• Checking Medicare Savings Programs and Extra Help

Part D spending averages (2024)

Source: CMS Medicare Part D Spending by Drug (Drug Spending Dashboard), release RY26 P04 V10, data through 2024 (DSD_PTD_RY26_P04_V10_DY24_BGM.csv), downloaded 2026-10-30

Companies covering this drug

Part D and Medicare Advantage plan sponsors that list this drug on a formulary, 50 at a time.