Hello again, I am reaching out once more.
I was prescribed this medication and havent started taking yet, but after reading up a bit on it I am wondering about it. If anyone has experience with it can you let me know about it. Also is it safe to take wth apixaban. I have been prescribed the lowest dose to take once daily to stabalize my heart which is constantly all over the place, afib, irregular heart beat, flutter. I would appreciate so much to hear back from anyone.
I do not have any experience with amiodarone. There is this information from ePocrates epocrates.com/online/drugs/...
Black Box Warning
Appropriate Use restrict use to indicated life-threatening arrhythmias due to drug-assoc. toxicity; initiate tx in a clinical setting with available continuous ECG and cardiac resuscitation
Pulmonary Toxicity hypersensitivity pneumonitis or interstitial/alveolar pneumonitis in 10-17% of pts; abnormal diffusion capacity w/o sx more common; fatal in 10% of pts; obtain baseline chest x-ray and PFTs, incl. diffusion capacity; repeat hx, physical exam, and chest x-ray q3-6mo
Hepatotoxicity common but usually mild w/ only elev. LFTs; overt hepatic failure can occur w/ few fatal cases; obtain baseline and periodic LFTs; D/C or decr. dose if LFTs >3x normal or is 2x elev. baseline; D/C if liver injury s/sx
Proarrhythmic Effects arrhythmias worsened, significant heart block, or sinus bradycardia in 2-5% of pts; effects prolonged vs. other antiarrhythmics
The patient education leaflet comes with this information.
Amiodarone injection is for use only in life-threatening situations. You will receive this medicine in a hospital setting.
You should not receive this medicine if you are allergic to amiodarone or iodine, or if you have a serious heart condition such as "AV block" (unless you have a pacemaker), a history of slow heart beats, or if your heart cannot pump blood properly.
Regarding drug interactions, there is this warning.
Avoid/Use Alternative amiodarone + apixaban monitor bleeding s/sx; if also combined w/ strong CYP3A4 inhibitor, decr. apixaban dose by 50% or avoid combo if already on 2.5 mg bid; if also combined w/ moderate CYP3A4 inhibitor, consider decr. apixaban dose: combo may incr. apixaban levels, risk of bleeding, other adverse effects (P-gp-mediated transport inhibited)
It sounds like your arrhythmia is quite significant. In the context of a co-occurring MPN, there could be significant issues if it is not addressed. The question is whether this combination of medications has a risk-benefit profile that matches your needs. None of us have all of the information nor the expertise to say whether this is the right choice for you.
Suggest that you consult with a MPN Specialist regarding this treatment plan. In addition, get an independent second opinion from another cardiologist. It is important to ask about all treatment options and do a through review of the risk-benefit profile of each choice. Review your choices with a MPN Specialist yourself and have the MPN Specialist consult with the treating cardiologist.
I have an arrythmia and PV. I opted for a catheter ablation to treat the paroxysmal atrial tachycardia. The surgery was successful. It was the right choice for me. You will have to determine what the right choice for you will be,
