Amiodarone

[farewelltoarms]

What is anyone's experience on the loading dose of Amiodirone. I was put on it about a week ago. Not terrible but vey unsteady and out of body feeling. I want to have a successful experience and get back in NSR so will put up with anything. Chronic persistent afib. Failed ablation and cardioversions. My EP told me that I have severe enlargement of Atrium. Any comments would be appreciated.

[PurpleGirl05]

I had no side effects with the loading dose of amiodarone. Or with the maintenance dose. Will be quitting cold turkey in a week to see if ablation was successful. Good luck to you!

[farewelltoarms in reply to PurpleGirl05]

Thank you. I have had vision issues and balance issues. Hopefully will improve.

[mav7]

May I ask how long you have had persistent AFib ?

Same status, have been offered Amiodarone.

[farewelltoarms in reply to mav7]

I think for over a year. When I first developed afib 4 years ago was hospitalized put on meds and cardioverted. That lasted 1 years. Then another cardioversion that lasted 2 years. Next one lasted three weeks. Thats when my Cardiologist told me I had chronic persistent afib. Never heard of it before that. The PA in his office told me they could not do anything for me. Changed physicians had an ablation also short term results. Cardioversion that lasted three days now on the Amiodirone. Feel so much better in NSR so hoping for better results. When told I had chronic by first physician they told me I would just feel worse and worse

[mav7]

Thanks for the detailed reply.

I have read some have CV to put in NSR then put on Amiodarone or another antiarrythmic drug to maintain NSR.

You are still fairly early in the process so hope for your success.

[farewelltoarms in reply to mav7]

Thank you.

[Davekh]

This is my second round on Amiodarone. Went into AF after a good 6 year period following ablation in 2017. The Amiodarone didn't put me back into NSR straight away but had a CV in December and have been in NSR ever since. Both time I didn't experience any side effects but I know this is a very individual thing as many others have done. I am waiting on a second ablation next month which will be part of the EPIC study run by Sussex University. Hopefully if successful I will be able to ditch the Amiodarone. Like other have said, you are early on in the process, Amiodarone is a very good drug and I'm sure everything will settle down for you.

[farewelltoarms in reply to Davekh]

Thank you.

[Rosie0202 in reply to Davekh]

Please keep the forum updated as it's important to know how effective amiodarone is.

[Visigoth]

I felt a bit weird during the loading period, and a bit unsteady sometimes. But it settled down after that and I’ve felt really well on it. No AF since I started.

[farewelltoarms in reply to Visigoth]

Thanks how long did it last?

[Visigoth in reply to farewelltoarms]

I would say the weird feeling lasted about two weeks and after that I gradually felt better and better. Before starting on amiodarone I’d been feeling dreadful with PAF and constant ectopics.

[farewelltoarms in reply to Visigoth]

So encouraging and helpful

[Visigoth in reply to farewelltoarms]

I should have added that after about a year my dose was reduced from 200mg to 100mg, as it was reducing my heart rate quite a lot as well as dealing with the rhythm. It still works just as well for me and I’m happy to be on the lower dose as I’m likely to be taking this long term.

[Rosie0202 in reply to Visigoth]

Hi

Do you get any really bad side effects. I have refused Amiodarone due to the toxicity. Did you have NSR on the loading dose. Also on the 100 mg maintenance dose did this still work as effectively as the 200 mg.

[Visigoth in reply to Rosie0202]

I get monitored with blood tests etc every six months to check that my thyroid, liver etc are all ok but I’ve had no bad side effects. The only small thing is sensitivity to the sun but as long as I wear a hat and factor 50 I’m fine. I stayed in NSR from about the second day on the loading dose and the 100mg maintenance dose has been just as effective as the 200mg. It’s also preferable from my point of view because research shows there’s no notable evidence of bad side effects on the low dose. I was terribly scared of taking amiodarone when I started because of the possible side effects but I’m so glad I did. It’s honestly been like a wonder drug for me.

[Dodgerguy]

I live in the U.S. and was 49 at the time I was taking it ( (50 years old now). I was recently diagnosed with AFib and put on it after a weeks long stay in the hospital on IV Digoxin. I was on Heparin and Metoprolol. I was naturally back in NSR by this time but it took several days. Once I went home they put me on Eliquis, Amiodarone And Metoprolol. During this period I was not able to sleep through the entire night. I’d wake two to the hours after falling asleep. I’d cat nap during the day as I was off from work. Not sure if this had anything to do with Amiodarone, but my gut told me it was. When I had a follow up with my primary care physician (GP) told me he was against the decision to put me on Amiodarone. He thought there were safer alternatives but he left it up to the Cardiologist. After seeing a EP I was taken off Amiodarone immediately cold turkey. He said there were safer alternatives if I needed a rhythm medication and I was too young. By this time I was off Eliquis. I now take 50 mg Xl Metoprolol once a day. My experience is short but wanted to share.

[farewelltoarms in reply to Dodgerguy]

Thank you. I am on the same combo of drugs you were originally on.

[Rosie0202 in reply to Dodgerguy]

Hi,

What safer alternatives did the EP recommend.

[Dodgerguy in reply to Rosie0202]

He didn’t mention any alternative. He was taking me off the rhythm medicine altogether. He said if needed in the future there are better options.

[Rosie0202 in reply to Dodgerguy]

Oh thats such a shame he didn't mention the better alternatives.

[Dodgerguy in reply to Rosie0202]

I agree ! Medical in the US is a joke.

[ochinee]

Didn't do a loading dose, went straight to 200mg daily in place of Sotalol in preparation for the Wolf Mini-maze surgery (started about 8 wks pre surgery that I had in Sept 2024).

Just finished Dr. Wolf's instructions for tapering off, 3 times a wk for 6 wks, once a wk for 6 wks.

Difficult to tell if Amiodarone is responsible for any of my side effects as I've been taking Coreg 3.125mg twice daily also.

I have some blurred vision at times, some exhaustion (not nearly as bad as with Sotalol).

Probably another 3 months or so before the Amiodarone is gone from my system so maybe I'll know better then.

[Rosie0202 in reply to ochinee]

Please keep us up to date on your progress.

[fcmdl]

I too had persistent Afib with complications. I was referred to a Professor doctor with a combined Cardiology/Pharmacology speciality at our local university. I could not handle a large dose of amiodarone due to other necessary medications, due to epilepsy, and felt quite ill with amiodarone. I was referred to the Speciality Afib clinic at the hospital, where I was closely monitored - great help! He decided that I did not have to take the normal amiodarone dosage and cut it in half. He advised that he believed that it would simply take more time to regain sinus rhythm. He was correct. I am back in sinus rhythm and did not have to suffer the side effects of the higher dosage of amiodarone. You may like to consider the same.

[farewelltoarms in reply to fcmdl]

Thank you

[Rosie0202 in reply to fcmdl]

That's interesting because I recently read a paper where they had trialled the lower dose and it was just as therapeutic as the loading dose.

[mav7 in reply to fcmdl]

Great you are in NSR !

May I ask how long you had been in persistent afib prior to taking amiodarone ?

[Rosie0202 in reply to fcmdl]

Thank you. That's really helpful. It was my instinct to believe that a lower dose could still be therapeutic. I'll discuss this with the EP soon.

[farewelltoarms in reply to Rosie0202]

Still on the loading dose and still in afib since Jan after failed ablation

[Renault6]

Hello I was loaded with amiodi rone 5 years ago when first in AFib & it converted me back into NSR mercifully no outstanding side effects only told to keep out of the sunDo hope it works for you & good luck

[Rosie0202 in reply to Renault6]

Have you been Afib free since then

[Renault6 in reply to Rosie0202]

aPeriods of AFib but very short lived & found taking magnesium citrate has really been beneficial in limiting ectopics.

[Pommerania78 in reply to Renault6]

How much magnesium do you take? Thanks.

[farewelltoarms in reply to Pommerania78]

None

[Ppiman]

"Out of body" feelings are, I think, called "depersonalisation". These can arise because of a slow heart rate, as well as having something called a "wide QRS" or "right/left branch bundle block" (which can also cause a slow heart rate and shows on an ECG as a wider P wave, perhaps with a small dimple on its peak).

I wonder, might the amiodarone have caused bradycardia or something? There's a good online study on this drug in case you have any fears of it - well worth reading. Search for "low dose amiodarone side effects" and you'll find it. Also, be sure to have regular medical assessments of any side effects in the lungs, eyes and thyroid, if I recall. I have read that an initial chest X ray is needed before treatment begins so there is a "before" to compare any "after" against.

Steve

[Gunn61]

I was loaded with Amiodarone in late December after my AF broke through on Bisoprolol and Sotalol. The AF persisted and I had an abalation at the end of January. I continued with 200mg dose per day after the ablation but after experiencing some vision issues (high light sensitivity and blurriness) in March, I reduced the dosage to 100mg per day in consultation with my GP. I have had some episodes of nausea since but none in the last couple of weeks.

Not sure if the vision and nausea issues are coincidental or amiodarone side effects, but I will lobby to wean off it when I meet with my EP in early May given the significant side effects of this drug and my lack of AF since the ablation. I have been using 50+ SPF sunscreen when I expect to be exposed to the sun and get regular blood tests to screen for other side effects.

Hope this helps.

[Kevin2331]

I too had severely enlarged left atrium for years. I ended up having open heart surgery to repair mitral and aortic valves in 2021. My left atrium was still normal size as of Oct. 2024. No afib since.