Amiodarone

Can you tell me what medication they put you on instead of Amiodarone?

When I was taking Amiodarone, I dropped into severe bradycardia with lung toxicity. My pulse dropped to 32, and I passed out. At that time I was no longer in AFIB. After I had a pacemaker implanted, I was out of AFIB for 1 year and 7 months. With that new episode of AFIB, I was put on Sotalol. After a month on Sotalol, I spontaneously converted back to normal rhythm. That lasted about 1 year and 4 months when I went back into AFIB. I then was put on Flecainide. After 3 months without converting, I had a cardioversion 2 days ago (so far, I am in normal rhythm). The electrophysiologist wants me to continue to take Flecainide for maintenance. In addition, I am taking Metoprolol, which I have been on since the beginning. Hope this is not too confusing. As you see, I have been on several different meds. Please let me know if you need any clarification.

I was on Amiodarone for about 5 years and had no serious side effects except noticeable sun sensitivity; I sunburned easily and learned to protect my skin. My resting heart rate dropped to the low 50's which was not ideal but was manageable. Tested regularly for lung and liver toxicity.

Will be starting amiodarone shortly and concerned about side affects; have one kidney and macular degeneration. Had ablation two weeks ago but now need cardioversion Any advice? Thankyou

@debroo
Make sure you talk to your doctors about taking Amiodarone and the side affects. When you get the prescription look at the side affects and what to report to your doctors.

I was on Amiodarone back in 2015 for several months after multiple ICD shocks. I asked to come off based on toxicity and my EP (electrophysiologist) agreed.

Took several months to slowly weaned me off. I then went through blood tests, and eye exams for the next 10 years. I just had a eye exam and no damage was seen to eyes and I was advised could stop being seen for amiodarone toxicity.

Then in February I had 3 ICD shocks and put back on amiodarone. It worked though and glad it was there to keep me out of tachycardias. I just had ablation surgery on LV for PVCs. It worked but still have other PVCs areas issues.

I take another medication called Mexiletine which helps with PVCs and PACs. Both together do a good job on preventing sustained VTAC and reduce incidents of PVCs. EP is deciding of slowly coming off amiodarone slowly again, taking Mexiletine away or leaving me on a very low dose of amiodarone.

My EP said if this was 10 years ago like before he would take me of amiodarone because of life expectancy. I am 79 now so my life expectancy (my words not his) is much less and being on a low dose of amiodarone is not such an issue as before.

I never had any side affects from amiodarone when taking or any toxic damage after. You will be tested for toxicity. Amiodarone is a powerful drug but it works.

@debroo My first ablation was a mess, unfortunately, and I was in the local ICU within six whole days, flat on my back. The attending did manage to get ahold of my electrophysiologist, and between the two they agreed to put me on amiodarone. This was a seven week prescription...only. A trial, if you will. It worked to stabilize my rhythm, and for that I will always be grateful for the Bright Bulb who invented that drug.

I made a face when the attending told me of their recommendation. 'That's a pretty big hammer, ' I said. He looked at the ceiling for a second and then said, 'But it's the RIGHT hammer.' Overnight, my rhythm corrected, I was discharged, and I went on to load the first week at 800 mg (400 mg BID), and then two 200 mg tablets BID for four weeks. I commenced a taper at the five week mark for two weeks. I was taken off metoprolol the same night they gave me amiodarone, and stayed off it.

As our experienced friend jc76 has stated, it's a toxic drug that uses iodine as its chief therapeutic ingredient. Like any drug, some, a few, will do very poorly on it right away. They just can't do it. Most others will do okay on it for a while, but may develop toxicity in their lungs, their eyes, their liver, even in their thyroid. So, you MUST BE MONITORED OFTEN and CLOSELY for at least the first month on this drug. Ask about how often they intend to check up on your markers!

All that red lantern waving aside, there are scads of patients who have been living very well on amiodarone, thanks very much, for literally years. ..upon years. If that's what it takes, what else are ya gonna do?!?

So, the takeaways are as follows:

It's a generally safe drug that packs a powerful punch. It can spank a cranky heart into whimpering.

It presents a significant potential for toxicity to one or more important parts of the body.

There should be a plan in place, expressed to you verbally or in writing, about how you're to be monitored for markers suggesting you need to reduce the dose, increase it, or eliminate the drug entirely.

Dear Glooming I can’t express in words how thankful and appreciative I am for your letter. Thankyou for being so candid, truthful, and honest. They have not mentioned at all about being monitored; Thankyou immensely for this information!! If I could get off my 200 mg of metoprolol succinate I would be so grateful. I cannot Thankyou enough for your informative and uplifting words. I hope you are continuing to do well; I hope that if ever you need advice someone like you is available to help you as you did me❣️Thankyou again from the bottom of my heart; your words really hit home for me❣️Sincerely Deb

@jc76 Thankyou for your valuable information about it being a good drug and how well it works. I’m glad to hear you had no side affects after being on it for so long and how it helped you with all your issues. I hope you continue to do well; thankyou again for sharing your information; I truly appreciate your information and your time in replying. Thankyou, Deb