amiodarone side effects/dose

[Lovepainting]

Hi - I’m 71 diagnosed with persistent AF .. had one failed cardioversion - now in second week of loading dose of amiodarone. Today Kardia said I’m in sinus rhythm which is great but my HR is around 50 and I feel v nauseous, tired etc. I’d like to go into the maintenance phase now (200 a day) as I may be having too much (I’m quite small) but have 4/5 days to go to complete week two. Hard to take it feeling like this! Does anyone know how long these symptoms last? Thank you!

[mav7]

healthunlocked.com/search/p...

No experience with amiodarone, but widely discussed on the forum (see above links)

You should recieve many replies from those with experience. From reading, seems to be very effective in maintaining NSR but dosage and side effects need to be closely monitored.

[CDreamer]

What was your loading dose?

Maintenance dose can be as low as 100mg/bd which my husband has been on for something like 4 years, 200mg prior to that for about 2 years.

Suggest you go back to your doctor and discuss as soon as possible. Obviously we cannot possibly advise you as Amiodarone is a specialist drug normally monitored by the cardiologists.

[Jajarunner]

Once you've done the loading phase you can discuss with your EP about reducing the dose. I was on 100 which worked well for a year. Some EPs will go as low as 50 for older or smaller patients. My EP said we would try for the lowest Dose which still works as that will have least side effects. Hang on in there because amiodarone worked like a charm for me. As soon as I came off of it I got tachycardia 🙄

[Lovepainting]

thank you - my loading dose was week one 200 3x a day then week two 200 twice a day then 200 a day. I have actually brought forward the maintenance phase by a few days. I will aim for 100 a day though and need to speak to doctor (first doctor appt 5 Feb!); been under a nursing team only so far. Helpful to know that 100 a day is an option.

[dogsneedwalking]

Hello there. My first experience of Amiodarone was after a failed Ablation last March. Unfortunately my heart wouldn't convert back to NSR so I had to be given Amiodarone intravenously [loading dose but not sure amount]. I spent a day in CCU whilst having this but on discharge 10 days later was prescribed 200mg once daily. I was discharged but still in SVT so was also taking 5mg Bisoprolol once daily. I did, however, have a Cardioversion again in September the same year which put me back into NSR for a short while and my Amiodarone dose was reduced to 100mg once daily. I must admit the nausea disappeared to for a short while, but, yes is was awful for months on end and quite draining mentally and physically but I continued to take it as Cardiology advised me it was the only drug that was keeping my heart in a normal rhythm and I trust their advice. I am now in the position of nausea is back and so is the Arrhythmias/AFib. I would say to stick with it as it gave me a 'normal' period of actually feeling great/loads of energy for almost 8 months. I have, however been advised that they cannot increase my dose of Amiodarone and Pace/Ablate is my only option now. My heart rate varies from lowest 39bpm to high 60's - I fluctuate between Bradycardia/NSR/Highest recently 183bpm but only lasted 1/2 hour. Lower heart rate I take my time getting up out of sitting position and out of bed in morning and I don't panic really as it can make your symptoms worse as I am sure you know already. Take care.

[Lovepainting]

thank you for this - it is such a journey isn’t it … I’ll try and get down to 100 and see - but I agree will be good to enjoy the benefits of NSR when the nausea calms down 🤞 I hope that your treatment will be helpful - I always imagine that a pacemaker might well be more straight forward - my father had one and it gave him a new life!

[CDreamer in reply to Lovepainting]

Worked for me, but not always straightforward and Pace & Ablate has to be an option for when all else fails as it will leave you 90% dependant upon the pacemaker. Everything has pros and cons.

[fcmdl]

I hear you - I was on started on 2 x 200mg amiodarone and felt absolutely horrible. My cardiologist sent me to a joint specialist Dr. in both cardio and pharma. The main reason is because I also have epilepsy and take Dilantin (phenytoin) and clobazam to prevent seizures, but unfortunately they should not be taken with amiodarone, so I have blood work done every week to monitor levels of both. I told him that I reduced the amiodarone to 1 x 200 as I was so fatigued and nauseated among other symptoms. He had no problem with my doing so to let my body get use to the medication. I am now up to 1.5 x 200 and feeling not great, but ok. He said taking a lower dose only means that it will take longer to work, but that I would get there nonetheless. Also take other meds - Diltiazem, Metformin (for long term prednisone induced diabetes) plus others, so I was definitely feeling very toxic. I don't know your history but think it might be helpful if you asked your cardio if you can start with a lower dose to allow your body to get use to it, and then gradually increase it. I know some people have a loading dose, but this was not done with me, presumably because of the Dilantin. Sure hope you feel better!

[Visigoth]

I had the loading dose for the first two weeks like you, then the maintenance dose of 200mg for nearly a year, then dropped to 100mg and have been on that ever since. I’m also elderly and small. If you can, I would try to hang on in there. I felt nausea for the first couple of weeks, and just weird in a way I can’t easily describe. But after that I realised more and more that I was actually feeling pretty good, and since then have gone from strength to strength feeling really well. My dose was reduced because it was lowering my heart rate a bit too much. I’ve been on amiodarone for three and a half years now and it’s been like a wonder drug in terms of my quality of life. I’m aware of the potential side effects of course but I’m monitored regularly.

[Hartingdon]

I reduced to 100mg which lessened the side effects, then Doc said I could stop. Bear in mind it takes a while (maybe couple of months) before it is out of your system.