Experience with amiodarone?

You can google amiodarone and read up on it. It's a rough drug that may or may not take care of whatever arrhythmia you are experiencing. It is iodine-based which, unfortunately, makes it toxic long-term. It's not a drug you can use indefinitely like metoprolol or aspirin, or apixaban, statins, etc. It is especially hard on the kidneys, the liver, and on the pulmonary veins.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7199124/
https://www.jcvaonline.com/article/S1053-0770(20)31174-5/abstract
This is surely frightening, and I get it. However, amiodarone stabilized me when I had to go to the ER six days after my index ablation (first ablation) due to runaway AF. My electrophysiologist answered the phone when the internist called from the ER and the two agreed I should try amiodarone. It converted me overnight (long story, but I had to overnight in the ICU). I went on 400mg BID (twice a day) as a 'loading dose', for one week. Then, 200mg BID for four weeks, then one 200mg tablet each day for another two weeks ( a tapering of sorts), and then off completely. I experienced none of the possible symptoms that you'll find when you google amiodarone. However, the cautions are there for a reason, and you should be secure that you will be closely monitored for the duration to ensure you aren't developing toxicity.

Why not diltiazem and dofetilide, or propafenone, or Sotolol, or Tikosyn...? Ask that question. BTW, I believe that at least Tikosyn also needs a cautious start, sometimes in hospital.

@insley
I see @gloaming has given you some great advice.

Back in 2016 I had 5 ICD shocks within 24 hours and was hospitalized. I was put on Amiodarone. It did wonders to get my heart beat back to regular rympthm.

However after I was released (5 days later) I researched the drug. Wow the information on it and the toxic affects it can have were overwhelming. I asked my EP to help wean me off of it. He did and we slowly moved off the amiodarone. I now take a medication that has a very low toxic side affects.

Has your EP or cardiologist mentioned Magnesium to you? This was recommended by my Mayo EP to help with my PVCs. I take 400 mg of magnesium citrate which did help lesson PVCs. But please check with your EP or cardiologist before you start taking supplements.

On the other side, stress and anxiety play a big role in PVCs. PVCs, cause anxiety and stress and anxiety and stress can cause PVCs. So important to address it mentally as well as physically. I am not sure if you are able to exercise but finding something that you like can really help. How about a hoppy? Doing something you enjoy each day can really help lesson your anxiety, stress and depression.

I remember reading a book about FDR. He was under tremendous stress in WW 2. What he did to reduce his stress and anxiety was to work on his stamp collection.

Thanks for your thoughtful and informed response. You mention weaning off amiodarone in favor of a different drug; what drug and dose?
I exercise in the gym 1 hour and walk 3 miles per day most days. So, I get plenty of exercise which I totally enjoy. And I am not aware of the PVCs during exercise!

In addition to Flecainide 100mg BID I take diltiazem 120mg ER BID, and a Mg supplemental (Heart Calm).

Yes, I appreciate that stress and anxiety contribute to the magnitude of PVC symptoms - I’m working on that component!
Your thoughts here are most appreciated.

@insley
After I weaned off amiodarone I was still was having a lot of PVCs and occasional AVIB. That is when I went on 400 mg of Magnesium and it did help.

I had radom episodes of tachacardia (that was short lived) and my EP wanted to address the PVCs and tachacardia by medication first not another ablation.

Now I list the medication but with caveat that this came from my Mayo EP and may not be the best for you. It is called Mexiletine. I take the minumum dose 150 mg tablet. Now Mexiletine does not built up in the body like amiodarone does with the toxic risk it poses. Thus you have to take the medication every 8 hours to maintain levels in your blood stream. That is the only negative.

My tachacardia stopped. I have a ICD/Pacemaker which records all my heart activity. The first 3 months after I started taking Mexiletine the tachacardia episodes were 0. The amount of PVCs went from every 5 beats to random isoloated events quite an improvement in PVCs that my EP AND I were very happy with also.

But again taking this medication came from my Mayo EP and the entire medical team at Mayo Jacksonville were all coordinated with starting a new medication and all approved. I read a lot of post that indicate others have had good success with other medications as well.

What I like about Mexiletine in addition to working for me was the low toxicity of the medication. But that low toxicity requires you to take it every 8 hours because the body eliminates it unlike amidarone. But for me that was a minor thing.

Good luck!

Hello!

I took amioderone for almost a year. It caused bradycardia requiring a pacemaker and elevated my liver enzymes as well.
I have recently been diagnosed with pulmonary hypertension. I have no family history and no other conditions but a fib (now managed be sotalol) and occasional tachycardia. BEWARE amioderone.

Amioderone is a "drug of last resort" - as I understand it - so is that where you are now ????

What about Dofetilide?
https://www.mayoclinic.org/drugs-supplements/dofetilide-oral-route/description/drg-20063516
I took Amioderone for 8 months in 2021 - it sucks imo

'...You mention weaning off amiodarone in favor of a different drug; what drug and dose?...'

Whatever instructions that accompany a professional prescription....that is what you should follow. Do not dick around with drugs on a whim, or on the advice of strangers....please. Not me, not anyone posting here.

Hi, my daughter was put on Amiodarone for non-sustained V-Tach. (She had several issues with her heart which included Hypertrophic Cardiomyopathy and several different problems with the electrical system of her heart.)
Amiodarone worked very well in her for the NSVT but it also caused hypothyroidism in her along with restrictive lung disease. She had to stay completely covered, including wearing a large rim hat during the summer or her skin would burn horribly even on cloudy days. There are a lot of side affects to this drug, bad ones, that's one reason it is classified as a last drug of choice.

@gloaming
If you can see from my post the emphasize is going through your doctors to see what is best for you as what works, or one may not be best for you.

I even post a caveat when asked about what medication I take. I have passed on to my doctors about supplements and medications that have been mentioned on MCC so that my doctors recommend which medication I should take not what others take.

Some of the OTC recommendations I was told not to take some others say try as we don't see any contradictions to trying it.

As you can see almost everyone has and had a different reaction to Amiodarone. It is an immensely powerful drug and does what it is supposed to do but all research shows it does have a high toxic effect on the body.

The bottom line is always check with your doctors about any medications and OTC supplements and follow what is prescribed to you.