Experience with amiodarone?

May I ask what dosage of amiodarone you were on that resulted in the eye damage? And did they front-load you with 400-800 mg, as is usual?

I have no eye damage per se, and certainly nothing that could be attributed to amiodarone. Were you perhaps mistaking me for another poster? If it was something I said, please refresh my memory and I'll clear it up.

I was six days post-ablation and had gone to my GP per the instructions handed to me by the nursing staff at the cath lab. My GP detected that I was fibrillating when he felt my wrist pulse and asked me to go to the ECG lab at the hospital. I was admitted immediately based on the findings. My rate was 180 and up, but with rapid ventricular response (RVR), meaning I had to have the rate controlled down to 100 or less within 24 hours....ideally. With consultation, the internist in the ER said he would start me on amiodarone with 400mg BID (twice daily) for one week. This was the loading dose. For the next four weeks, I was to take 200mg BID, and then two weeks with one 200mg tablet daily.

Thank you for responding, I was replying to @jc76 but something went awry. I was very interested in how they handled your loading dose. I am considering amiodarone because my AF episodes are every 1-2 weeks and my mother never had another episode (nor ANY side effects, amazing) once she got on 100 mg daily of amio. But I'm aware that there is a cumulative side effect re the eyes & other organs. I wonder if that can be avoided with frequent eye checks. Thanks again!

Hi - in my experince, frequent eye checks will find the damage [after the fact] and exams will not prevent damage. My eyes were damaged within the first 3 months of use.

As woodside replies just next to this post of mine, amiodarone bears watching. It may or may not reveal its deleterious effects on an organ until well into the prescription's duration...depends on the person, the dose, other comorbidities and drugs being taken at the time.

I may have forgotten the details of this conservation, so forgive me, but if I were you, I would consider an ablation. If such an intervention is likely to stem the arrhythmia, that is what I would choose over drugs, but especially amiodarone. Amiodarone, according to what I have found on line, and to what my prescribing emergency doctor told me as I was flat on my back looking up at him, is not a long-term drug if it is issued in a daily dose upwards 200 mg. But, what if YOUR reaction to even a paltry 100 mg is not good?

I hasten to add that the drug is amazing: it got me out of my persistent AF, and severe bradycardia associated with metoprolol, over night. Admitted near noon, and by breakfast next morning I was ready to be discharged because I seemed to be in stable NSR, and remained so until about 12 days into the 'weaning' final two weeks of only 200mg PO. I went back into AF, and was told to do two more weeks on 200 mg BID, which was the maintenance dosage the previous three weeks. Amazing as amiodarone is, at least for me, it also carries warnings about pulmonary vein hypertension, kidney and liver problems, bluing of the skin, especially when exposed to direct sunlight, and yes, eye problems. So, I got in line right away with the same electrophysiologist once it was certified (he accepted the ECG downloaded from my Samsung Galaxy 4 watch as evidence) that I had in fact reverted to AF again.

@drdianeschneider
You replied correctly putting in @jc76

I was going to send you a private message as was dealing with something. However I decided to do on open forum. First my experience with Amiodarone was at Mayo Jacksonville Emgergency Room in 2105. It was serious. I had 5 ICD shocks within 24 hour period.

I had a ICD/Pacemaker implanted in 2006. I did not have any shocks until 2015.

EMS rushed me to Mayo Emergency Room. I was admitted and received a IV drop of Amiodarone. I wish I could tell you the dosage but don't know. I stayed on the IV drip until dishcharged and then started pills.

The amiodarone did work then and all the time afterward. But my EP nor heart failure doctor (Mayo) had prescibed it it was the emergency room cardiologist.

I did research on amiodarone and was concerned with toxic affects of it. I did not want the possible toxic side affects. I point this out as what one person tolerates in their body is not what another does or will have. It is a personal decision that each person needs to make based on what their research reveals and the advise from their own doctors.

My Mayo EP agreed to wean me off amiodarone. I was on it several months and then started to wean me off. What I had to do was slowly (months) decrease the dosage and was able to get off it. Did I have shocks after that, yes years later but isolated and mostly from some problems with pacemaker programming and wire issues

I would suggest you do some reasearch on amiodarone and see the toxic affects. Your mother is on a very low dose and thus toxic affects would be less but something her EP or cariologist should advise. What I am saying here is that one person can have a reaction or toxic response to a low dose where anohter will not. We are all different and thus one person can have side affects and one will not.

If you are having AF every 1-2 weeks does not sound serious. Are you saying isolated episodes or continuous into AF? My question is why MCC members should not try to give medical guidance but their experience and knowledge of their treatments.

My suggestion is talk to your cardiologist or EP about the toxic affects of amiodarone low doses and high doses. Then decide if you want to take the possibility of having it or look at other medications they can recommend.

I wish I could give you dosages I received but the emergency room cariologist was trying to stop my tachacaria NOT AFIB. So my dosage was problem much higher.

I was told to monitor through exams, blood tests, eye exams for possible side affects damage from being on amiodarone. I did follow up every year from 2015 eye exams that showed no damage to my eyes. My other tests did not show any damage to other organs that can be affected also.

The eye exams will show starting of damage and can be addressed to prevent form getting worse. The issue is that you are considering being on amiodarone on an ongoing basis where I was weaned off it. It did take several months to wean me off as the dosage was slowly reduced.

I hope this answers your questions. I apologize for not answering you earlier. I was not going on MCC for a while.

Thank you so much, @jc76, for giving me so many details. I have relatively short AF episodes (not persistent) of 2-4 hrs which flecainide stops, but I'd prefer not to be having any, ha ha. But since mine are mild, HR stays fairly low, I have low BP normally, etc., we figure I'll keep using flec as "pill in pocket", ie., as needed, and keep amio in reserve. You've been through a lot but I'm so glad to hear amio did not harm your eyes, etc. Thank you again, and best wishes for healing to both of us!

I am adding more comments as to personal experience of taking Amiodarone. I was put on 400 mg daily of Amiodarone when I first went into AF. After several months I was having a lot of difficulty breathing. I was told it was the AF.

Things got worse, and I went into bradycardia; my heart rate was in the 30's, and I could barely walk across a room. At that time I had been on Amiodarone for just over a year; of course, I was taken off of it then. Since I was told that it stays in your system for 6 months, no one knew if my systems were due to the Amiodarone or something else.

Meanwhile, I saw a pulmonologist who determined that the Amiodarone was extremely toxic to my lungs. I started on steroids for that. I had no other damage to eyes or any other organs (as far as I know).

An episode in which my heart stopped and I passed out resulted in an emergency pacemaker. I have since had 2 other episodes of AF. I have taken Sotalol and Flecainide and am currently on 100 mg of Flecainide twice a day in hopes of preventing more AF episodes.

As gloaming said, "Amiodarone bears watching". Amiodarone works well for some (as indicated above). However, for me it is a "poison pill" (designation given by my pulmonologist).

Thanks for sharing. FWIW I’m doing pretty well on 100mg Flecainide BID. Occasional flare ups of PVCs come and go. Never been able to confidently identify a trigger. But anxiety definitely increases intensity during episodes of high burden (40-50%).

Thank you for your message. I appreciate knowing that you are doing well on 100 mg Flecainide BID, since that is what I am also taking. I agree that anxiety increases this type of problem. When I was diagnosed earlier this year with CLL and scheduled for unrelated surgery, my anxiety level was high; I then went into AF - hence the Flecainide. Stay well!