Amiodarone dosage

It isn't toxic so much on dosage, although if you ingested 2000 mg twice daily you'd soon be in trouble. Instead, the 'loading' dose can be between 400 and 1200 mg for the heavy majority of cases, and it goes by time....or number of doses. In my case, it was 400mg twice daily (BID in medical parlance), so 800mg, and that went on for seven days. Thereafter, two pills each day for five weeks, but now down to 200 mg. So 400mg daily. At Week 6 I was to commence a two=week taper of only 200mg, one tablet each day.

Patients on amiodarone are supposed to be monitored closely for the first few weeks to see how their systems tolerate it. The optic nerve, kidneys, lungs, and liver are all key places to look for loss of function, hypertension, or other deterioration.

My research, and the gentleman internist to started me on it when I was in the ER with a runaway heart a week after my first ablation, both suggest that you can be on amiodarone for a good long while if you tolerate it. I'm talking about 6-8 years. However, everyone concerned would much prefer that is is used only strictly as long as it is absolutely necessary, so weeks, months, a couple of years ideally.

I have no idea why amiodarone and not one of three or four other possible drugs (flecainide, Multaq, Tikosyn, propafenone), but obviously your care team carefully considered key factors in your case and decided that they needed the Big Hammer right away. Happened to me, and it has happened to many others. It's a good drug, safe for short term use (in most patients, not all, and that's why monitoring is important). Enjoy being free of arrhythmia, and once you have an ablation, you should be off it. In fact, if I were an EP and wanting to see a heart in its natural state, warts and all, I would ask the patient to stop taking anything except the anti-coagulant all AF patients should be taking. Amiodarone, since it has a very high residual value (half-life) for weeks later, should reasonably be stopped at least two weeks prior to the ablation. Again, IF....IF....I were a health expert, and I'm no such thing, I would want my patients' hearts to be free to behave as they really are, including beating chaotically so that I can nip the rogue cell structures and get the arrhythmia to stop.

Regardless of my sentiments expressed here, I'm not qualified. I don't know you. Your cardiologist and EP do, or will, or ought to, and you should always attend carefully to their instructions.

That's the kind of question you should ask a doctor or pharmacist. I was on it for a while with no side effects. It's a weird drug. Good for the heart - bad for everything else! Good luck.

My cardiologist called it “poison.”

@jimhealthy Never met him/her but would agree.

Ditto….. our EP doesn’t like the drug either

For me it was length of time not dose. Ivee been off of it since my transplant but it did become toxic to me after 10 years I was on it. Its true that other medications were tried first but when I didn't do well on those the last resort was Amiodarone, Its as some have said a great medication for the heart but not everything else. I loss my Thyroid because of it and the tops of my ears got a bluish tint to them.

The side effects of amiodarone are very much dose-dependent. My mother has been on it at 100 mg per day for 25 years (yes, that's YEARS) without a single bad side effect. But she religiously gets her tests at intervals for eyes, thyroid, liver, etc. , as recommended. If flecainide ever stops working for me pill-in-pocket, I would not fear moving to amiodarone low dose. However, I do not believe the loading dose should be so high, as I think that primes a lot of people for side effects; I am a research dr and I have that debate with my own cardiologists... who admit that they don't really know a lot about amiodarone--yet they prescribe it at high dose. I do believe it is inappropriate for drs to refer to amio as "poison", since there are thousands of people for whom it works extremely well. (almost 2 million prescriptions are written for amio annually in the US) Researching & talking w/ other patients, I find that too many drs are leaving patients at higher doses without considering that 100 mg may be effective. A short trial at low dose might answer that question for patients. Something to discuss with your dr. Wishing you a peaceful heart and NSR in your journey!

I would not say our EP says that it is poison…. He just makes a face… you do have to go into the hospital for three days so they can regulate this drug and my husband’s fear is he won’t come out.

@bobarb
I did NOT have to go to the hospital when they started me on amioderone.

You are apparently one of the lucky ones…good luck to you..sounds like you have it handled