Amiodorone

[Enobarbus]

Hi all, I'm a 73-year old male, living in Brisbane Australia, recently diagnosed with AF. After a failed cardioversion, I've been prescribed Amiodorone (after having a bad reaction - acid reflux - to Sotalol). How dire are the side-effects of Amiodorone? The list looks worrying!

[Hidden]

Hello Enobarbus and welcome to the forum. I have no personal experience of Amiodorone but can understand your concerns. It might be a good idea to type Amiodorone into the search box top right of this page because there have been a large number of posts about it over the years. As I understand it, it is a highly effective rhythm drug but as you say, it can bring with it some unwelcome side effects and it’s best to avoid long term use if possible. It can have a major impact on the thyroid for example. However, if it successfully controls your AF, especially if you you have another CV, it could mean that other treatments such as an ablation might work for you. Very often, the drug is taken for a limited period before and after either procedure to give the heart the best possible chance of remaining in rhythm. There are also some who have taken it longer term without any apparent problems so I guess like most things medical, it’s the luck of the draw.

If you are new to AF, take a look at the pinned post “useful links for Newbies and Oldies” where you will find easy access to lots of useful information about AF. Hope you find it helpful......

healthunlocked.com/afassoci.........

[CDreamer]

I posted a question about titrating down from Amiodarone quite recently - quite a few very interesting replies - Particularly from Jonathon Pitt Crick - who has you may know, is a renowned EP - worth taking a look at the thread for that alone.

Yes Amiodarone is a drug with horrible side affects but it is also the best gun in the drug armoury to convert you to NSR. Some people tolerate it and others don’t - as you have discovered not every drug suits every person. My husband had persistent AF with failed cardioversion so was recommended to take Amiodarone — history is in the thread.

It may be worth exporting other options such as ablation but if Amiodarone is the only option left on the table it’s worth a shot if you are very symptomatic - as long as you are very well monitored - bloods every 3-6 months and report any sort of side affect immediately.

The alternative is accepting persistent AF, which many people do and continue to have an acceptable quality of life. I think it depends upon your situation and just how symptomatic you are.

I’ll post a link to my thread

[CDreamer]

Hope this helps

healthunlocked.com/afassoci...

[Hidden]

Yes, amiodarone is potentially extremely toxic. However one has to consider the context in which it is prescribed. A short course before and after electrical cardioversion (DCCV) is common if initial DCCV has been unsuccessful. Similarly, a couple of months treatment after ablation for AFib (PVI) is sometimes given.

Long term treatment with Amiodarone is much more problematic. I feel this a situation where the patient must not be a passive recipient of treatment. Regular monitoring to identify possible organ damage, particularly to thyroid, eyes, lungs and liver is necessary. I think NHS patients must take the initiative to make sure this is carried out.

Having said that, with proper monitoring and the lowest possible effective maintenance dose, the long term use of amiodarone can be justified, though in my non medical opinion, this should ideally be under specialist supervision, working with the primary care physician.

ncbi.nlm.nih.gov/pmc/articl...

derbyshiremedicinesmanageme...

[Kaz747]

Amiodarone is usually a drug of last resort. It can be very effective for some people. I was on it for a short time a couple of years ago (in a cocktail with Digoxin and Atenolol). I had go off it after a couple of months as it affected my skin, liver and lungs - there wasn’t any permanent damage thankfully.

It’s important to stay out of the sun when on Amioderone (I live in Perth).

[etheral]

Ask your cardiologist if Tikosyn (dofetilide) is available in Australia. I am a 69yo male whose afib has been well controlled without side effects for 3 years. Tikosyn has none of the potential long term consequences of Amioderone. It does have to be started while you are monitored in the hospital for 2-3 days. Best wishes...

[Rubymurray25]

I have been on Amiodarone for 7 months as it was the only drug in hospital that controlled my AF of 8 years. I wrote a couple of weeks ago explaining that following an annual test how my optician was very concerned at the deterioration on the surfaces of my eyes and my very high pressures and made an immediate urgent request to see a consultant. I have had my first examination and am going tomorrow to discuss the next stage and options. I wrote to my heart consultant making reference to the list of " Don't take if's " with the drug , the eyes issues being listed, he suggested I stopped and went cold turkey and see what happened ( i am on the list for a 3rd ablation so he thinking might be this could speed things up! ) . I am an optimist and am hoping that the drug has had a calming influence after my two ablations and that the eyes will improve once the drug is stopped. I had a blood test last week and my Thyroid is ok and my liver only slightly raised but all over drugs have had that effect with the liver. As we all know we are all so very different and how drug control is so much trial and error, but I would clearly state that Amiodarone has been brilliant with controlling my AF 10/10 .I do like the suggestion from Etheral and the Tikosyn , I might ask my consultant about that one!Good luck.

[Ianc2]

I think I would be looking to get an appointment with an EP regarding an ablation as soon as possible.

[john-boy-92]

Some people tolerate Amiodarone and the related Dronedarone. Others like me, end up with symptoms that are very like a severe case of COVID. Things to watch out for: coffee coloured urine, blood oxygen at 93% and falling, a raspy sound in the upper lungs that sounds like Velcro being pulled apart. Some people also have thyroid issues, susceptibility to cataracts, and skin sensitivity to UV. It's probably not a good idea to be on this for the long term.

I was on Dronedarone and I did not tolerate it. When I was admitted to hospital the second time, I had mild AF. They put me on a saline drip and, although they didn't tell me, the drip bag was marked as containing Amiodarone. I was being treated by young doctors on what was in effect a geriatric ward. Those young doctors didn't listen to an elderly "know it all" patient, so they carried on with diagnostics for community acquired pneumonia (that I didn't have), and discharged me when antibiotics didn't work. I was admitted again within days, hypoxic with blood oxygen at 73%, and close to critical twelve hours later and arguing strongly not to be put on a respirator in ICU. Reactions to Amiodarone and Dronedarone aren't recognised by a lot of doctors.

[Weldon123]

A couple of years ago I tried a low dose of amiodarone, stayed on it for six weeks and stopped cold turkey because I felt like the walking dead. I did not have an AF episode for six months after that which indicates how long it will stay in your system. I had had AF for 18 years at least twice a month before that. Last January I was put on flecainide, for the heart rhythms, and digoxin for the heart rate at the lowest dose possible. Have not had an episode since! A couple of weeks ago I cut my pills in half, and so far so good. I am not recommending this, as everyone is different; just telling you my experience. I don’t feel great, but certainly not so bad as with amiodarone. Ask your md About multaq (dronedarone) in the same family as amiodarone, but without the awful side effects. It did not work for me, and I was up to once a week episodes lasting 24 hours, which is when I went to an EP, not just a cardio doctor. He was much more knowledgeable about AF and put me on the right path. There are choices, so do your due diligence. I wish you well.Gilgamesh.

[Slidingdoors99]

Hello. Just to say that we’re on the same path (which I know doesn’t really help!)I’m on amiodarone (week 5) and I’m very worried too! 😞

[Ducky2003]

If you check the link to posts CDreamer gave you above, you will see my post. I have got eye issues and have to remind the GP about monitoring but it's a necessary evil at the moment for me.

[cuore]

I have taken three -- at different times--- anti-arrhythmic drugs: Amiodarone, Flecainide and presently Propafenone.

Amiodarone had too may side effects for me and cannot be taken long without damage for most. Flecainide was the period pre my second ablation. Propafenone I have been taking after my third ablation for almost 19 months (in sinus) although planning to stop. After the initial side effects of Propafenone, I am fine with it. What I am trying to day is that you have choices, so you could ask your care giver why specifically Amiodarone was chosen.

[Jeans1234 in reply to cuore]

Thank you, this is very helpful info

[Slidingdoors99]

Hi again. I have been on amiodarone for five weeks now and my bloods have shown that unfortunately they are effecting my thyroid and my blood sugars are raised.Some people though I know have no side effects at all, so it really does depend.

Please just make sure they check your blood regularly.

[Enobarbus in reply to Slidingdoors99]

Thanks, that's really useful to know.

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