Amiodarone dosage

I also did NOT have to go to the hospital when I was started on Amiodarone. However, I was started at a very high dose (400 mg twice a day), and I experienced lots of side effects, including lung toxicity.

We were told the very reason for going in the hospital is to monitor the ups and downs of the medication… Sorry to hear you’re having issues

I also learned (after the fact) that most people do go into the hospital for monitoring when being started on Amiodarone. Unfortunately, my cardiologist just started me on a high dosage which caused issues. However, I no longer have the issues because I am off the drug. My pacemaker controls the bradycardia (and passing out) it caused, and a great pulmonologist treats the lung toxicity. Obviously, Amiodarone works for many people. However, I do believe that it should be closely monitored - which was not my case.

I started Amiodarone the day I got home from the hospital on Sep 2 after having cardio version that morning, which brought me back into normal sinus rhythm. The first three days were 400mg three times a day (1200mg total per day) for three days. Then my dosage dropped to 200mg once a day. All of this was done at home and in anticipation of catheter ablation scheduled for Oct 8. On October 1 I was instructed to stop the Amiodarone and I had the ablation the following week. I told my EP that the Amiodarone made me feel terrible and the drug must be toxic. From what I have read, it has an extremely long half-life. I gradually began to feel better a few days after the ablation and continue to do so. If you are told you need an ablation, I would recommend you get it scheduled.

@drdianeschneider
I went to my primary care doctor for unrelated issues, February 25, 2025, double ear infection and infection in throat. When nurse was taking my vital signs that when my afib was found. EKG confirmed it. 2 weeks later I went to a cardiologist where he prescribed Amiodarone 200mg once a day. 2 weeks later he did a cardioversion 200 joules one time, and I was back in rhythm. I still take the amiodarone, not sure why, and was referred to an electrophysiology and he gave me two options, amiodarone or ablation. This is where I get scared, complications from either option. I have lung tests, TSH, liver tests and all is good so far.

@todd1968 You will lose nothing by seeking a really good EP for a consultation. The idea is to get the ablation before you progress/if you are progressing to more advanced stages of AF with its attendant unhealthy changes to the heart.

Ablations have been undergone successfully for millions by now, and they have been doing them for at least 20 years, with improvements all the time. It has an exceedingly low risk of complications in the right surgery/right EP. If by chance yours is not successful, you still have two options: try again (I did, with the same EP, and he succeeded in ridding me of the AF, now going on 31 months!) or resume the drug regimen.

I hasten to add that I am not a health expert by any means. I am just a semi-educated reader and watcher of sometimes technical videos about cardiac electrophysiology, arrhythmias, and their treatment (although I know much more about AF than I do the other typical arrhythmias). My point in reaching out to you is that, in my uneducated opinion, you risk of developing eventual toxicity or just systemic intolerance to amiodarone is many times higher than is the risk for a single attempt at ablating the disordered tissue, wherever it happens to be in your case. Just something to chew on.

Todd1968….. in Arizona they put you in the hospital. They don’t just put you on that drug… Ablation is always a better choice before taking the drugs… Sometimes ablations don’t work and at that point you need to look for something else… Good luck to you.