Amiodrone

[Norfolk_spaniel]

I have just been told that I will have to take Amiodrone followed by a cardioversion in 5 weeks time. As somebody who could not tolerate flecaincide and who struggles to tolerate a lot of medication, this makes me nervous.Any experience of it out there please?

[Desanthony]

I had no problems with it whatsoever when I took it for my second successful cardioversion. At the point I should have been taken off it a blood test found my thyroid count was up by 3 points - had no symptoms and within 6 weeks it was back to normal. No symptoms at all.

[Jalia]

I've taken it many times mostly for short periods. No real problems other than that an IV Amiodarone didn't work in converting me to NSR!

[Hidden]

I have no personal experience but I know many who have been in your position and have said the experience was not as difficult as they anticipated. It’s a good idea to keep an eye on your thyroid function but hopefully all will be well. It will certainly improve the chances of having a successful cardioversion……good luck

[Norfolk_spaniel in reply to Hidden]

Now worried because I've just read the NICE guidelines which say it should always be administered initially in secondary care and various functions monitored i.e. in hospital . My arrhythmia nurse has asked my GP to prescribe it so obviously no close monitoring. I cannot even have a blood test at my local surgery. Help. I'm desperate to feel better but really worried about this medication.

[Desanthony in reply to Norfolk_spaniel]

This I believe us when it is being given in high doses to get you back into NSR - called a chemical cardioversion.

[Hidden in reply to Norfolk_spaniel]

It's worth checking with you GP but I think Desanthony is right. Generally regular daily maintenance doses are lower, certainly the case with Flecainide but I’m not medically trained and have never taken Amiodarone.

[MummyLuv in reply to Norfolk_spaniel]

You should have blood test before starting and at week 3 and week 8 in order to check thyroid, liver and kidneys. If your GP surgery can’t do then they need to arrange to have it done elsewhere, I’d ask them how this can be done and if that fails get on to your cardiologist (or whoever is doing the cardioversion) to have it arranged. Short term low dose Amiodarone usually has no side effects but it can do. I had trouble with my liver toxins and so came off the drug earlier than planned to avoid damage. Thyroid being knocked out is more common. The monitoring is vital in my opinion.

[javo123j]

Like others I took it before a cardioversion over 3 years ago and had no problems and I was in sinus rhythm for two years before afib returned

[CDreamer]

Amiodarone can cause problems - mainly Thyroid, lung and skin photosensitivity but it’s also the most affective antiarrythmic there is and taking it short term will give you the best chance of the cardioversion working and the lasting.

Having said that, I would insist on monitoring at least Thyroid prior to taking and 2-3 months afterwards. If you GP is un-cooperative then go back to your arrythmia nurse and ask the hospital to do it or at least write to your GP requesting they monitor you. Stay out of sun and wear sunscreen every day, even in the house and if you develop a persistent cough get straight back to the arrythmia clinic.

It’s really a roll of the dice as to who reacts and who doesn’t. My husband has been taking it for over 3 years now and touch wood, very little reaction but his quality of life has improved a lot because it’s rare for him now to have AF, whereas he was persistent and the cardioversion wasn’t successful in converting him to NSR - but he did convert after about 8 weeks on Amiodarone and NSR has been maintained ever since.

It really is your decision. Where you given other treatment options?

Best wishes

[Mickey16]

Hi Norfolk_spaniel,This is a difficult one. I recommend you look at the Amiodarone medication information sheet. I took Amiodarone for a month before having a second cardioversion. I had been advised it was for a short time only and that there could be side affects, but because it was for a short period only, that this would not be a problem.

However, I became very ill in that short time from Amiodarone. I had a personal history of Bradycardia and as you will see from the Amiodarone information, Amiodarone is not recommended for that condition.

All I would say is, try and understand your medical condition and tendencies, as you say you have intolerance to some medications and ask questions of your GP/Doctor. The decision is yours and if you do take Amiodarone be aware of the potential side affects and follow them up promptly. I too have an intolerance to certain medications.

[etheral in reply to Mickey16]

In the states it is recommended that you have pulmonary function studies before and frequently while talking Amioderone as it can cause irreversible pulmonary fibrosis.

[NannyNooNoo in reply to etheral]

They should do that in the UK too. My OH took it and it caused lung damage, which was only discovered because he caught pneumonia; he also had bad reactions to the sun and corneal deposits 🤦‍♀️🤦‍♀️

[Rubymurray25]

I was put on Amiodarone as it was IV drug that worked whilst in hospital to stop a prolonged AF episode, I was ok for 7 months and the only thing it did to me was cause an eye issue so was then put on my current med of Dronedarone ( from the same group of meds ) and during the 15 months have been checked regularly and all good.

[Hidden]

Hello, you may find it helpful to take a look at our patient resources webpage heartrhythmalliance.org/afa... where we have an information sheet about Amiodarone. Alternatively, you may like to contact our Patient Services team who can offer you further support and guidance: [e-mail]

Amiodarone info sheet

[Ducky2003]

It's very common to give it on the lead up to cardioversion as it gives a better chance for you to remain in NSR following it. I have been on and off it for the past 4 years. If its short term, it should be fine but longer term, you would just need some monitoring.

[Norfolk_spaniel]

Thanks for that, I've read it and am even more nervous. I've reacted badly to medication in the past and my mum died at 63 from a bad reaction to medication, I'm 69. The arrhythmia nurse said he was going to email my GP so hopefully I will be able to discuss it with her. I've read the NICE guidelines which state that it should be administered initially in secondary care after a chest xray and blood tests so I don't understand why this has been passed to my GP. However, I'm desperate to feel better. I have almost constant heart palpitations, have zero energy and nausea. Managed to get a shower this morning but then had to go back to bed.

[Jajarunner in reply to Norfolk_spaniel]

I was given it in hospital (I don't think GPs can prescribe it without specialist instruction) but just to take at home. This was despite me taking verapamil, collapsing and being rushed into hospital in an ambulance!

[Jajarunner]

I took it for six months pre and post a cardioversion and ablation. No problems. I'm looking at using it long-term next if dronedarone doesn't work, my heart was steady as a rock and I had no discernible side effects. Good luck x

[Jajarunner]

Ps hubby watches a cardiologist in YouTube talk about amiadarone and he said he's never known a case of toxicity in the lower doses used these days. You do need regular blood tests and to avoid the sun or wear SPF 50

[Visigoth in reply to Jajarunner]

That’s very interesting as I’m on a low dose myself. Do you know who the cardiologist is?

[Jajarunner in reply to Visigoth]

Sorry, no. He just searched amiadarone on YouTube and this guy popped up.

[Visigoth in reply to Jajarunner]

Thanks - I’ll try the same search!

[andyk0001]

Hi, my wife did not want to take Amiodorone after her cardioversion because of the potential side effects. However, a few days after the cardioversion her afib returned. She took the Amiodorone and the afib immediately stopped. She continued with it for a few months then on the advice of the cardiologist stopped taking it. The afib has not returned. She did not have any side effects from the Amiodorone. Hope this is helpful.

[ETHEL103]

Hi my first cv lasted only 2 hours .Since then I have been lucky enough to have a flutter ablation.I have been invited for another cv as hospitals don't share info.Obvs I wo t need it fingers crossed but in my pre assessment call before I knew I was having ablation they told me about taking ameriodone.I said I would rather try without it and asked if there was another rythmn drug.No reply was their answer.Hope this rather muddled answer is as clear as mud.lol.

[Visigoth]

I’ve been on amiodarone for 15 months and no problems at all apart from the fact that it lowered my heart rate a lot so my dose was reduced to 100mg. I believe as others have said it only has to be administered first in hospital if it’s much higher doses. You should have baseline blood tests to start with and then every six months. In my case my cardiologist told the GP I would need regular monitoring but it was the pharmacist attached to my surgery who put all that in place. The GP just reviews the tests. Maybe you could contact the pharmacist if your surgery has one? But the Arrythmia nurse should be able to tell the GP anyway - I don’t see how the GP can refuse to do the blood tests. Incidentally, I also couldn’t take flecainide but am fine on amiodarone. Clearly there are some people who suffer from the side effects - and I realise I may do down the line - but my experience has been only positive. I felt dreadful before I started it - my QOL was absolutely wrecked, but it has been completely restored!

[MummyLuv]

I took Amiodarone before and after my mini maze. Like you I was worried but took comfort from a low dose (200mg) for a short time 4 months. Every surgeon I spoke to use Amiodarone (unless there was a medical reason why it couldn’t be used).

It was instructed by my surgeon but administered by my GP. Your cardiologist should have instructed the GP to do a baseline blood test. Followed by week 3 and week 8 follow ups. This is to mainly check thyroid function as if the iodine was to interfere it happens quite quickly, they also check your liver and kidney too. If your GP surgery can’t do blood tests (which is very unusual) then the cardiologist should arrange where they will be done.

Amiodarone is the ‘daddy’ of Anti Arrhythmics which is why it is used in these circumstances.

[BStanding56]

I took it for 6 years, had no symptoms whatsoever, kept me in sinus rhythm, would not hesitate to take it again

[Visigoth in reply to BStanding56]

Could I ask why you stopped?

[BStanding56]

Visigoth, look at my past posts. Because my Af was so symptomatic I was given a pacemaker and amiodoryn which worked really well for 8 years, I was going through a very stressful time and my Af returned and became permenant. They felt the Amiodoryn was no longer keeping me in sinus node so it was discontinued . I had no synptoms on it and I cannot be thankful enough that it kept me in sinus rhythm after 4 years of very symptomatic Af

[Mayophil]

I developed Afib post heart surgery and my Doctor ordered a front load of Amiodarone, 400mg twice a day for one week, then 200 mg one a day. He said he could admit me to hospital to start the regime but he felt my thyroid and felt I was fine to start at home. By the third dose I was out of Afib. The Cardioversion was on the 14th day (It worked) and I continued taking Amio until the 40th day. (I think my Doctor forget to tell me I could have stopped taking it sooner.) I was also on Warfarin and the pharmacist told me that Amio will accelerate the anticoagulant (INR) so I had that checked twice a week the first week then once a week. On the 21st day my INR was up to 3.4 and on the 39th day got up to 4.4 (Yo!) then after stopping Amio it slowly stabilized as the Warfarin was adjusted every week. It was a little scary to me to have my INR get up to 4.4 even when the Warfarin dose was changed weekly trying to adjust to it.On the 30th day on Amio I woke up with blurry vision in just my right eye. I tried drops to clear it but that didn't work. I saw my ophthalmologist who thought the sudden onset strange and that my right eye lens was thickened but not cloudy, and only the right eye lens - a big change from the previous year. It looked like a cataract but the sudden onset was odd and that it was clear. I searched medical sites and found a case of exactly the same thing on a 68 yr old patient attributed to Amio but both my cardiologist and eye doctor felt being on Amio for just over one month wouldn't do that. I'm not convinced but a cataract is not the end of the world and can be removed but I feel worth mentioning. No other symptoms and it got me out of Afib quickly which was a great relief. Good luck to you and as other have mentioned, it seems that thyroid changes may be the biggest or more frequent concern to Doctors but that was not an issue for me. Blood Tests before and after remained normal.

[Singalong1]

This was a question that I planned to raise, too! I’m still waiting to hear from the arrhythmia nurse ( working with Dr Husain Shabeeh Kings College Hospital London) to arrange a cardio version using amiodarone. (I’ve been waiting since early April - obviously very busy).

I too am very concerned about taking amiodarone, having read up on its potential side effects.

I’m 69. I was diagnosed with Afib in June 2019. I’m now in persistent Afib with Afib induced mild heart failure! I don’t want HF to get worse. But I am very worried about the effects of amiodarone. (Not least because I am also taking the corticosteroid Predisolone for Polymyalgis Rheumatica).

In my last telephone appointment with Dr Shabeeh, I raised my concern about this drug and he advised I could try for CV with just beta blocker (Bisopherol), but he wouldn’t recommend it. And advised I should talk it over with the arrhythmia nurse when they call.

Thank you for the post Norfolk_Spaniel, and to all who have responded with your experience. Very helpful. Please let’s us know how you get on, N_S.