Drug Amiodarone

[Mercia]

Does anyone on the forum have any experience using amiodarone for A-Fib/Flutter. Have heard that it is referred to as one of the ugly medicines!

I am currently using Lasix 20Mg daily, Zocor 40Mg daily, Metoprolol 50Mg 2x a day and Amiodarone 400Mg daily and Cumiden 2.5Mg daily except Mon, Wed, Fri, I take 5Mg=(INR +-3.2)
My Cardiologist suggests that we keep this dosage until my cardioversion on 08/14.

I had my Mitral Valve replaced with a On-X mechanical on 06/24/2008, and they also did a modified maze procedure to eliminate my A-fib (worked for first 2 weeks post surgery)

 

[AgilityDog]

Yes, I was on it for 3 months post op. I had the full Maze procedure in addition to the valve. It is controversial because it has long terms toxicity issues. Please run a search in this site for it - you'll find all the discussions.

 

[ALCapshaw2]

Amiodarone is the SLEDGE HAMMER of antiarrhythmics.

It also has a laundry list of Side Effects, some of which
can be quite serious if you are overdosed or have taken
the drug for too long.

Even the manufacturer has a warning in their information sheet that it should be used as the antiarrhythmic of LAST RESORT. The FDA also has a warning notice about it's use that seems to be ignored all too often.

Some (many?) DOCTORS seem to like to use Amiodarone "because it works" and they can get their patients out of the hospital faster. It is common to use a "loading dose" for a short period of time to 'saturate' the cells of your body, then to drop to a lower level (I'm thinking 200 mg) for maintenance. You may want to check that number.

Several of the members of VR.com have found that SOTALOL (generic form of BetaPace) works quite well at controlling A-Fib, often at fairly LOW doses with minor side effects (dizzyness is a common early side effect that goes away as the body adjusts to the medication). The manufacturer recommends starting while IN HOSPITAL for a few days "just in case other (possibly dangerous) arrhythmias occur as the body adjusts.

Look at the TOP of the page for the Blue Line.
Click on "Search" and type in Amiodarone.
You will find links to MANY discussions of this drug.
Also GOOGLE "amiodarone", read the information sheet (any pharmacist can give you one), or ASK any pharmacist for their information sheet. See the FDA warning. It is included in the GOOGLE links.

In case you haven't already figured it out,
I have a "thing" about Doctors prescribing Amiodarone as their FIRST line of Defense against post-op A-Fib (which is a fairly common post-op 'issue').

I have informed my Cardiologist that I will only consider Amiodarone after other measures have been exhausted or if I have a Dangerous Arrhythmia that Amiodarone (alone) can control. He seems to be OK with that philosophy.

'AL Capshaw'

 

[Ana]

My husband had his mitral valve replaced and went into Afib about 24 hours later. the put him on Amio (200mg) and did a cardioversion a week later. He kept irritating his heart with hard coughing due to all the fluid in his lungs. He went back into Afib a couple of weeks later, converted back on his own while in the hospital, but the docs put him on 400 mg of Amio for two weeks to make sure the normal sinus rhythm would stick. He then dropped back down to 200 mg for another 5 weeks and then was pulled off completely (a total of around 10-12 weeks). From what I gather, the mitral valve replacement surgery really irritates the heart muscle and causes a high rate of Afib among those types of patients (50-75%).

I hated that he was on the med because it was so toxic, but the alternatives for stubborn cases are somewhat limited. Additionally, if you look at the data, the harmful side effects are much more prevalent the higher the dose. However, I did find some studies that showed people being on the drug for years at 600mg a day and not having side effects, so it is not a certainty that you will experience a problem.

However, caution is a good thing with this med and with regard to my husband, I insisted that his weekly blood draws include a liver functions test to keep an eye on that. You should also make sure that you don't begin to have vision and breathing problems - another prevalent side effect.

That you will be on it for less than two months would put you in the low-risk category. If you are extremely worried then perhaps discuss an alternative med with your cardiologist? However, it would be my guess that since your maze procedure did not reduce your Afib, then your situation calls for the bigger sledgehammer of Amio than an alternate drug. I would call the cardio's office and ask to discuss your concerns if you are very worried.

 

[EireCara]

I took Amiodarone in 07 for about 6 months. It was great for the a.fib but I stopped it myself due to side effects. I was also cardioverted but the a.fib came back. Best wishes.

 

[Cooker]

Does anyone on the forum have any experience using amiodarone for A-Fib/Flutter. Have heard that it is referred to as one of the ugly medicines!

I am currently using Lasix 20Mg daily, Zocor 40Mg daily, Metoprolol 50Mg 2x a day and Amiodarone 400Mg daily and Cumiden 2.5Mg daily except Mon, Wed, Fri, I take 5Mg=(INR +-3.2)
My Cardiologist suggests that we keep this dosage until my cardioversion on 08/14.

I had my Mitral Valve replaced with a On-X mechanical on 06/24/2008, and they also did a modified maze procedure to eliminate my A-fib (worked for first 2 weeks post surgery)

Hi?.I want to say that yes it can have some nasty side effect but you may not be on it that long. I was on it about six months or so, 500mg/day with no problem. I had Ablation at the time of my AVR and that seemed to solve my problem with A-fib?I did have to be cardioverted once post AVR/Ablation?.so don?t give up?.It can take a while for the maze to ?take? from what I understand?. And don?t let anyone freak you out about the drug?.it is good to question your doctors but remember to go with your gut and the advice of medical professionals?.there is a lot of experience and opinions here but very few doctors?.I hope it never comes back after you are converted?.and the conversion was a piece of cake for me, hope it will be fore you.

 

[Lionheart]

Mercia,

I have some experience using Amiodarone for Atrial Flutter and have been on it for about 4 1/2 months since my AVR. I too was concerned after reading all the warnings about the potentially toxic side effects; but, I plan to continue at 200 mg/ day for at least 6 months total per my cardiologist's direction. Hopefully he will take me off the drug then, if not then I may seek alternative meds. The Amiodarone did not prevent me from entering flutter nor did it help me self convert after I got it. My A-flutter stopped after an electrical cardiovertion about 2 1/2 months ago.

As much as I don't "like" the drug, I hated A-flutter. While I think we must all be advocates for our health and I am not an advocate for Amiodarone; I accept its POTENTIAL side effects for its apparently POSITIVE benefits.

I have noticed no side effects that I can attribute to the Amio. To monitor potential problems (side effects) my Optometrist checks my eyes every few months and my cardio monitors my liver, thyroid, etc. with blood tests for thyroid stimulating hormone (TSH) and a Comprehensive Metabolic Panel (CMP).

Good luck with your cardioversion-mine was painless, smooth, and uneventful and I felt GREAT after it was over. I wish you the same success.
Take care,
John

Does anyone on the forum have any experience using amiodarone for A-Fib/Flutter. Have heard that it is referred to as one of the ugly medicines!

I am currently using Lasix 20Mg daily, Zocor 40Mg daily, Metoprolol 50Mg 2x a day and Amiodarone 400Mg daily and Cumiden 2.5Mg daily except Mon, Wed, Fri, I take 5Mg=(INR +-3.2)
My Cardiologist suggests that we keep this dosage until my cardioversion on 08/14.

I had my Mitral Valve replaced with a On-X mechanical on 06/24/2008, and they also did a modified maze procedure to eliminate my A-fib (worked for first 2 weeks post surgery)

 

[ALCapshaw2]

My Cardiologist told me that SOTALOL (generic form of BetaPace) specifically targets Atrial Fibrilation.

It works WELL for me. I take 1/2 of the Lowest Dose tablet in the morning and the other half in the evening. For a while, I was even able to skip the evening dose with no flareups. Several other members of VR.com have had similar experiences.

I wonder why more Surgeons (and Cardiologists) don't try Sotalol FIRST.

I would NOT be surprised if it all comes down to what gets patients out of the Hospital the soonest, i.e. the INSURANCE COMPANIES are driving the choice of Medication. (Or the Drug Reps)...

 

[hensylee]

oh, my, do we ever have information on amiodarone! do a search (above) as has been already mentioned in this thread and you'll find lots that you might not want to know. You will, I am sure, let your dr know that you now know what it is and he/she will hopefully work with you to get off it. There are other drugs that can be used. Wishing you well. Blessins.........

 

[kfay]

I was on amiodorone for about 2 months after surgery (cutting it short by about a month after repeated calls to all of my Dr's. requesting to go off of it). I didn't experience any problems with it but was terrified of the side effects after I was warned on here and then went on my own search for info. I also had a maze for a-flutter and to hopefully keep more serious rhythm issues at bay since they run with my abnormality. I think it takes a while for the maze to become really effective. By the way, have you every googled the maze procedure and see how they actually cut your heart and sew it back up for that? It kind of freaked me out.

Kim

 

[Mercia]

Thanks

Thanks

Thanks - I also did a search and read most of the posts/threads regarding Amiodarone.

I really do trust my cardiologist - I was on Digoxin and Cardizem SR for about 4 months pre-op and he put of the use of Amiodarone as long as possible.

Will let you know how things turn out

 

[offwego]

I remember taking Amiodarone for a couple of weeks after my MVR. I was spooked after I read about it..My mother had sent me a case of Grapefruits as a get well present..I noticed when reading about Amiodarone that grapefruits and citrus fruits could be a problem with it!

Thanks mom...lol..

 

[shellyb]

My husband was put on it in the hospital because of a-fib. He was on it for 2months after surgery with no side effects. After reading some of the info here I was worried about it.

shellyb

 

[Bridgette]

It is also important to remember that while a drug may have potentially serious side effects, not everyone is going to experience all or even any of them. And manufacturers HAVE to list every possible side effect - doesn't mean you will get them.

While it's good that Sotalol has worked well for some members here, it doesn't for everyone, and I am speaking from long experience - during the 12 years that I had intermittent AF Sotalol was not effective at converting it except for maybe the first couple of times. After that, it was either IV Amiodarone or the tablets to convert to sinus rhythm while in hospital, then home with Sotalol which helped to maintain a steady rate. Actually my GP told me that Sotalol started out life as a blood pressure medication then it was realised that it was useful for controlling heart rates - and I've read that it is more effective at controlling rates rather than rhythms?

As far as the Maze goes, my surgeon told me that it can take up to six months for it to become effective ie if you are still getting prolonged AF after that, then it can be judged to have not really worked.
Anyway Mercia, as Cooker said, don't freak out about it and remember that your cardio knows what he is doing and what is best for you.
Good luck.

Bridgette

 

[bvdr]

I was on the maximum flecainide dose for many years and started to have many side effects and wanted to get off of it. I was put on amiodarone for the first several months after I discontinued flecainide. It REALLY AFFECTED MY COUMADIN DOSE. I went from 6.5 mg a day down to 3.5 and then down to 3.0. Even after you stop taking it Amiodarone stays in your body a long time. I have been off it for months (?6) and I have just had to up my coumadin to 3.5mg. Just be aware that your anticoagulation dosage will need to be monitored frequently and expect some changes.

 

[sue943]

Initially I was on Amiodarone and Digoxin immediately after surgery to deal with the A Fib. I was supposed to take 200mg for a while then drop to 100mg but then I got toxicity from the Digoxin and had to stop taking that and just took Amiodarone - I can't remember the dosage now. I took it for several months with my cardiologist anxious to get me off it as soon as possible.

My thyroid is slightly underactive now, not sure if that was due to the drug or not. Apart from that I am unaware of any problems.

 

[jmrobbi]

I've been on it for 3 yrs since I had my heart surgery. The dr. tried a couple other drugs which did nothing and I could barely function as my a-fib was so bad so he put me back on Amiodarone and I've never looked back. Once in a great while I get a-fib (like once a yr and not like once a week which was the way it had been). I've been lucky with no side effects but I am on the lower dosage of 200mg. Like you I was really nervous about being on the drug in the beginning but for me it has been a life saver. Once in awhile I think maybe I should try a safer drug but I hate to change what is currently working for me.