Amiodarone

[higgy52]

When it comes to Amiodarone what does a long half life mean as people keep on about it,

Thanks

[Hidden]

Half life means the length of time the drug stays in the body

[CDreamer]

And the reason they go on about is because when it stays in your body it still affects everything in your body.

[BobD Volunteer]

I understand that it can remain working in your body for three or more months.

[bennie06 in reply to BobD]

No. Average that i can find is 50 days with a range of 20 to 100 days.

[jedimasterlincoln in reply to bennie06]

Well 90 days would be three months near enough so Bob isn't far off...

[Hidden in reply to jedimasterlincoln]

No he’s miles out as explained in my comment below.

[BobD Volunteer in reply to Hidden]

Please understand I was not talking about half life.merely how long it may affect you.

[Hidden in reply to BobD]

I’ll let you know how long the side effects last after stopping, I believe however that it would depend upon what dose and for how long it was taken.

[Hidden]

It is not as stated the time it takes for the drug to leave your body. One half life means the time it takes for 50% (half) of it to decay or leave your body. It is a term used in nuclear physics. So using the half life period of 90 days, which I have seen quoted on here, then after one half life you have 50% left . Over another half life, ie another 90 days you would lose half of what is left leaving you after 2 half lives (180 days) with 25% of the original.

Working it out after the 3rd half life (270 days) you will still have 12.5% of the drug and after the 4th half life (360 days) you will still have 6.25% of the drug in you body.

Drilling it down after the 7th half life (630 days) you will have less than 1% of the drug left.

[CDreamer in reply to Hidden]

Thank you for that excellent explanation - just one point - whilst that may be a calculation for elemental decay - would not the metabolism of a human being be a variable? ie - some people may be more efficient at expelling the drug from tissues than others.

[Hidden in reply to CDreamer]

No the half life is basically the decay life of the drug and as it is within the organs and tissues of the body you can’t expel it. I suppose you could get rid of a bit more if any of your organs were removed.

The one thing that made me think is that as I am topping it up daily then the half life is really irrelevant until you stop taking it. My cardiologist took me off of it two weeks ago thank goodness after two and a half years.

[Hidden in reply to Hidden]

Interesting.....I stand corrected !

[ILowe in reply to Hidden]

Yorkie1. Could you also comment on how long it takes for the drug to have only insignificant effects? For effects, I mean, on parts of the body such as lungs thyroid and heart. There is also the question of drug interactions, such as a 50% reduction in dose for Flecainide when you switch, and 30% reduction in Bisoprolol. My guess is, three half lives for body parts, and less for competing drugs like Flecainide.

[Hidden in reply to ILowe]

ILowe, sorry I don’t know the answers to that. I see the EP and will be asking exactly that as I have just come off it myself

[ILowe in reply to Hidden]

I would be extremely interested in the views of the EP and I think they would be helpful for others. I am reasoning from first principles, without the detailed knowledge of what actually happens as possessed by an EP. I only have highly questionable guesses, which function as working hypothesises because this is still better than no guess at all.

[Hidden in reply to ILowe]

I will add another response with his replies at the end of the week. I will be requesting a lung function test/chest X-ray/thyroid and eye tests as at now the end of the Amiodarone and compare the ones from the start of the drug.

[Hidden in reply to ILowe]

ILowe

Saw the EP today. Off Amiodarone for 2 weeks so far and he reckons another 6 weeks or so to stop effects, but will monitor it.

Booked me in for an Ablation in September rather than leave it and go onto Flecanaide which he says isn’t as good as Amiodarone for the sinus rhythm aspect. Reckons that as Amiodarone will have worn off then AF will probably return prior to ablation

[ILowe in reply to Hidden]

Interesting. Doctors do develop instincts, based on digesting many case histories, and this needs to be considered alongside other more objective indicators. This maps onto the side effects of Amiodarone being minimal after only one half-life or less (6 weeks, till September). He is obviously considering the power of Amiodarone to keep you in NSR.

But, the other concern with Amiodarone is its physiological effects on the thyroid and the lungs. And, I know for Warfarin the effect lasts at least three half lives.

Concerning relative effectiveness for NSR maintenance. There have been several head to head discussions about that. I do not have time to look in my files today. I think you will find that there is only a marginal benefit from Amiodarone in maintaining NSR compared with Flecainide.

[higgy52 in reply to Hidden]

interesting, was on it for 2 and a half years, stopped it 6 weeks ago probably thats why i've still got head ache then

[stix]

This post is now causing me anxiety, I was given Amiodarone in A&E to reduce my heart rate, intreveniously, should I be worried ?

I also am on Sotolol 120mg AM and PM which I have also seen on here is not a good combination.

What is all this leave the body talk ? Have I been given nuclear medicine or something?

[CDreamer in reply to stix]

No it’s not a nuclear medicine.

But it is a nasty, toxic drug which stays in your body tissues for weeks/months and it is very effective at stopping AF. There is normally no problem for short term use but can have very serious side effects if taken for months/years.

Also - Sotolol is no longer recommended in the U.K. for treatment of Lone AF but is sometimes used if you have other conditions as well as AF.

Always talk to your doctor about your concerns regarding drug options and know the risks/benefits - your body - your choice.

Best wishes

[bennie06 in reply to CDreamer]

All drugs can cause serious side effects. Suggest that you are over cooking it. Did you personally have a bad experience with this medication.

[Hidden in reply to bennie06]

Personally it kept me in sinus rhythm BUT I am now waiting for further tests as it has affected my lungs/eyes/thyroid and my gait

[paulh1 in reply to Hidden]

How come you stayed on the drug so long.? I was on it for a short period of time and was real wary and hesitant even with that small period of time

[Hidden in reply to paulh1]

I was on Bisoprolol first but went back into AFib so he offered me Amiodarone rather than have an ablation and only told me a couple of effects. Checked it after 3 months then went back after 12 months. They noticed some slight changes in lung, my eyesight prescription was changed a month later. So at this stage not much. Nine months later my eyesight prescription changed again, thyroid changes starting to show and walking as though drunk. The drug info sheet does say some minor problems in these areas but I kept pushing my GP. He never linked it but I started to read in here about Amiodarone and in a FB page and started to get concerned. GP still wouldn’t do anything and my cardio appt should have been January. I have other major illnesses including cancers and the GP kept saying it was linked to some other illness or chemo drug. In the end I wrote to my cardiologist and told him of my side effects and that I wanted off it ASAP. I got an appt straight away took me off it and EP appt this week. Although I would blame the cardiologist my main gripe is with the useless GP

[paulh1 in reply to Hidden]

Really sorry to hear that. If it hadn't been for this website and the people on it I would have never known about the side effects of that drug. So when they prescribed it for me I told them only for a 3 month period no more. They gave to me after I had quad bypass.

[higgy52 in reply to Hidden]

done my thyroid in and my eyes, no sleep

[CDreamer in reply to bennie06]

No - because I refused it when offered.

I can’t take any rate or rythm drugs anyway and yes all drugs have side effects but Amiodarone is particularly notorious and the effects can be, but are not always, serious. I don’t think that is over cooking it but I can see that it may cause anxieties. I also think people need information to be able to make informed choices. I always ask myself do I think I am going to be worse with or without this drug and for me - decided much worse. Very individual choice.

[Amcech in reply to CDreamer]

Us, anxiety! I experienced extreme anxiety while taking amio for 7 months. It never did stop my AF so my EP switched me to flecanaide. I have had no af that I'm aware of since starting the flecanaide. I believe stopping the amio lessened my anxiety about taking it which allowed my body with the help of the flecanaide to prevent af from recurring.

[Hidden]

Not nuclear but definitely toxic. I would check previous posts on here re Amiodarone, especially re side effects, and if concerned speak with your cardiologist.

[BobD Volunteer in reply to Hidden]

As one doctor told us at HRC last year Amiodrone does not have side effects. It has effects!

[jumped in reply to BobD]

If this doctor used Amiodarone he would certainly know about effects

[Bagrat]

verywellmind.com/medication...

nottingham.ac.uk/nmp/sonet/...

Nice little video in second link. Both more about building a steady stae when starting drugs but useful

[CDreamer in reply to Bagrat]

Thanks Bagrat - I like the 2nd video - the first seemed to me to more about drugs for mental health.

[Bagrat in reply to CDreamer]

True but the principles of half life and getting to a steady state are the same. I'm only guessing but maybe stopping one anti-arrhythmic and starting another may need to be gauged correctly too

[Hidden in reply to Bagrat]

When I stopped Amiodarone after 18 months on it I was put straight away on to Disopyramide , another anti arrhythmic drug.

[JoBrien]

Hi all

My husband was put on this drug after his 2nd cardioversion was unsuccessful. They took him off Solatol and replaced it with biosopol aswell. Since just had third cardioversion and thankfully has stayed in a rhythm, albeit slow. So now gp has lowered the biosopol to 2.5mg and kept him on the amiodarone. What is this drug actually supposed to do and I’m freaking out now hearing all the side effects long term and how long it takes to get out of your system. Hubby now having to do daily bpm etc readings as it was 48bpm and blood pressure really high on Friday. Any suggestions out there if we should be requesting eg should he come off this drug? Thank you in advance

[bennie06 in reply to JoBrien]

Please please please do not freak yourself out. Mr. Google can be most helpful and remember that this, whilst being well informed, is fundamentally a social media platform. Raise concerns that you have with your medical professionals. Your husband is in normal rhythm so celebrate the fact and Good luck.

[bushy2016]

I was told the only way we excrete amiodarone through our body is via shedding skin

[Ianc2]

My understanding is that a cardioversion is a test to see if the heart can go back into normal rhythm. If it can the next step is to actively consider an ablation and to arrange to see an EP. If necessary dig deep in your piggy bank for a private appointment. You will gain a much clearer understanding of your condition and be able to make much better informed decisions.