Dumping the Amiodarone....

[Dexter Bob]

My Cardio says I can dump the Amiodarone "cold turkey" on the 24th. When I went into the ACT clinic last week and told them, they thought it would result in cutting my Coumadin by 50%. My last test I was 3.2 .(Currently taking 32.5 mg a week) So I am a little nervous about the 6 days after I quit the drug and when I get tested on the 30th. Seems to me like my INR could go WAY low in that time period and I am risking a clot situation. Anybody have any experience with the way Amiodorone first affects INR when stopping the drug??

 

[Ross]

http://warfarinfo.com/amiodarone.htm

The really tricky part of managing the warfarin (Coumadin, Jantoven) - amiodarone interaction is when amiodarone is discontinued but warfarin (Coumadin, Jantoven) is continued. Because of its long half-life, amiodarone can take up to six months after the last dose is taken to be cleared from the body. This is so long that it is difficult to remember the amiodarone and realize what is happening. Typically a warfarin (Coumadin, Jantoven) dose increase needs to be made about three months after the amiodarone is stopped. Further warfarin (Coumadin, Jantoven) dose increases may need to be made up to about six months after the amiodarone is stopped.

Amiodarone may also affect the thyroid since it contains a lot of iodine. The thyroid also plays a part in warfarin (Coumadin, Jantoven) regulation, so this may also affect the amount of warfarin (Coumadin, Jantoven) which is needed.

 

[JimL]

According to the Physician's Desk Reference, amiodarone does double the effectiveness of coumadin.
I wonder if you don't want to consider weaning yourself off the amio, perhaps taking half pills a few days?
I suggest that no matter what you do, your INR is going to take some regulating, perhaps for a few weeks.
Congratulations on dumping the amio!

 

[bvdr]

When I have gone on Amiodarone I had to very quickly lower my warfarin dose. However, when I have come off of it the change was more gradual and the increase in my warfarin was also. The drug hangs around your system for a long time. I've been on it several times during the last few years but for less than 6 months each time. I think you may not even notice a difference in 6 days but your experience may be different than mine.

 

[Luana]

I dumped mine cold turkey a long time ago, back in mid January. Doctor said I only had to take it for a month, so when a bit past 1 month hit, I stopped. My PT/INRs have been good, consistently between 2.5 and 3. My warfarin dose has been lowered. While I'm taking 2mg 5 days a week, and 4mg 2 days a week, I think I might be fine on 3mg every day.
Luana

 

[Doug]

I had to increase my dosage of warfarin after stopping amiodarone. I guess I was weaned off of it, because the discharge instructions had me on 3 doses for a week or so, 2 doses for a period of time, and then 1 dose until I was out of the drug. I am staying around 2.5 - 3.1 mg while taking between 45 and 50 mg of warfarin per week (I am not going to give up my greens!).

 

[Cris N]

When I went into the ACT clinic last week and told them, they thought it would result in cutting my Coumadin by 50%. My last test I was 3.2 .

I think you meant to say the opposite.

I quit cold turkey after a month and I was nervous about it. My warfarin dosage needed to be increased fairly quickly. Knowing what I know now, I would probably scootch up the dosage a bit - maybe even 10%. If you do make an adjustment, make sure you tell the clinic so they can factor that in...

 

[bunker395]

My Cardo stopped my Amiodarone cold turkey and raised my Warfarin 20% at the same time which put my INR to the top of the range over time as the Amiodarone left my system I had to raise the Warfarin again but the 20% was right for me to start.