Dronedarone,yes or no.

[Bilzer]

Hi all, hope you are well. I recently had my medication changed from lowest dose bisoprolol 1.25mg daily to dronedarone 400mg twice daily EP, no real explanation as such, not sure if I want to take this drug, was just wondering if anybody has any advice regarding, or experience with this med. I would be very grateful. Diagnosed with PAF, three years ago, not really progressed since then, ( thankfully). I do get weekly set events that last no more than 1min. I also take statins and apixaban 5mg twice daily.

Thanks.

[BobD Volunteer]

Scroll back six messages and you will see you are the second to ask this today.

[Bilzer in reply to BobD]

Thanks for swift reply Bob, but unfortunately, I cannot do that.

[jeanjeannie50 in reply to Bilzer]

Go to just above your post and click on the heading Posts.

[john-boy-92]

Dronedarone is like amiodarone but without the iodine element to reduce side effects. I had pulmonary toxicity as a consequence of dronedarone and amiodarone. Pulmonary toxicity is rare - 6 cases in 100,000 - but it's effects on the lungs are similar to severe COVID and, the x-rays of my lungs looked the same as someone with COVID as you can see from the case paper.

I had been prescribed dronedarone for AF, but it was thought that I had pnuemonia and a ward (for geriatrics!) put me on a saline drip with amiodarone as I had mild AF (a side effect of being unwell). I had been misdiagnosed as having pnuemonia, then as antibiotics had no effect it was thought that I had cancer. I was discharged without any treatment or follow up. My GP was on the ball - my SpO2 was 76% - and told me to go straight away to the Respiratory Hot Clinic at North Bristol Lung Institute where they would be waiting for me. That night I was very close to critical, and had to argue strongly against against being sedated and put on a respirator in ICU. They wanted to ring my wife at 1:15 am because my best chance of surviving was 50%. Generally the prognosis for recovery is not good if you survive. I was very fortunate that Professor Millar viewed my x-rays, her deputy (specialist in interstitial cellular activity) was on duty that night and, the staff at North Bristol Lung Institute (Southmead Hospital, Bristol) were brilliant especially the night staff who recognised I was hypoxic and the ICU Sister who came to see me.

Symptoms of pulmonary toxicity to watch for: dry non-productive cough, blood oxygen (SpO2) at 92% and falling, antibiotics have no effect, "Velcro crackle" when breathing (sounds like Velcro being pulled apart), lung sounds are in a different location than pnuemonia, likewise masses within the lungs on x-rays. The published paper on my case is at dx.doi.org/10.4997/JRCPE.20... The treatment I had was 20 to 25 litres / minute of oxygen at 70% in hospital, then prednisolone for the following twelve months.

You may not have such a drastic reaction.

[Zacky19]

Hi. I would deff ask for explanation, seems very high ? I take 2.5 mg twice per day just to keep my heart from beating too fast as I still exercise about 5 times a week and after an Ablation 3 years ago so it was suggested as a safty plan. I don't have any side effects other that very slow BPM 45-47) maybe get second opinion ? Good luck.

[Tomred]

Hi i take 1.25mg bisoprolol plus 400mg dronederone twice daily I they do keep my rate and rhytym slowed down on about 2 years now I'm presently considering seeing gp about changing bisoprolol though due to breathlessness

[Bilzer]

Thanks for all replies, John-boy-92 wow, scary stuff, you certainly went through the mill. On the basis that my af seems mild by comparison to some here, I am tempted to carry on as is. There was not even a mention of blood tests before commencing with dronedarone for liver function, which, from what I have read is an absolute must. In the us thet are considered as a last resort drug, an d the cost of them by comparison to bisoprolol is exorbitant.Guess I will just follow my gut feeling for now. Thanks again.

[dh1120]

I took this medication for 6 months prior to my ablation. I had no issues or side effects. I was previously on Flecainide and it stopped working abruptly. I cannot take beta blockers. My EP said that all other medication options were to dangerous for me to take due to my age and that their side effects were way worse. I had to stop taking it 5 days before my ablation and was not put back on it afterwards. I believe everyone is different and every doctors reasons could be too.

[Bilzer in reply to dh1120]

dh1120 I agree doctors will differ with opinions and reasoning. My problem is that neither was relayed to me clearly. My next appointment is 12 months from now,and I am not keen on what appears to me a little experiment by cardiologist.

[dh1120 in reply to Bilzer]

I don’t blame you there. I would definitely be contacting your doctor to find out why first. Best of luck to you.

[cbsrbpm]

I am on 400mg twice a day, was put on it prior to cardioversion last December and have been taking it ever since. I was in a bad place though so would take anything they felt would help me. So far I am still in sinus (touching wood) I had an episode of about 3-4 weeks in January but have been in sinus since then. It is a very toxic drug and I may have to come off it as my liver function since being on it has been coming back as abnormal. Watch this space! If I were in your shoes I would hold off until no other option viable, bearing in mind I am not medically trained. Good luck.

[Bilzer in reply to cbsrbpm]

Thanks cbsrbpm. Liver function deterioration seem to be a common effect of this medication. Maybe it is better suited for short term use. I have decided to not take this drug presently, will stick with bisoprolol and see where it takes me. As I have said previously, my af appears mild in comparison. The cardiologist told me it has not progressed much before changing my prescription, go figure.