Amiodarone dosage after CABG

I'm a 63 year old male who had no risk factors for heart disease, exercised two hours a day, had no chest pain nor shortness of breath and had passed routine stress test with ease. However, after feeling faint lifting weights, an angiogram revealed major blockages and bypass surgery was done four weeks ago. It went well, except on the third day in the hospital I developed atrial fib which returned to normal rhythm in seven hours with the help of an IV drip of amiodarone. I was released two days later and sent home with orders to take 200mg of amiodarone a day for three months.

My strength is returning and i'm exercising about an hour each day with no ill effects.My blood pressure is good and I have a good appetite, The only other drug I'm currently taking is 80mg of pravachol daily. However, I'm really concerned about the amiodarone. I know this is really a nasty drug with several bad side effects. What I am experiencing now is almost constant anxiety with a feeling of heart palipations in my chest, but my pulse is always normal, and severe trembling in my hands.  I did have anxiety attacks before the surgery and essential tremor, but both are greatly amplified now..

Do you think the amiodarone could be causing this and does the dosage (200mg daily for three months) I've been given seem reasonable?

[Michael J. McWilliams, M.D.]

Amiodarone at 200 mg daily for several months after open heart surgery for atrial fibrillation is a common regimen.

I have not seen tremors and anxiety from amiodarone.  It is hard to say why you are experiencing those symptoms.  If you are worried about the amiodarone, ask your doctor if it is ok if you stop it early.

[Hopeful39]

I had presented with a-fib back in March (no blockage or other symptomes).  I also cardioverted on an Amiodarone IV loading dose.  My cardiologist then recommended 400 mg of Amiodarone for 3 months.  He indicated that the oral treatment was to control heart rate and to make the heart less likely to enter into a-fib when I experienced palpatation (which I have had all my life).  I too was concerned and discussed it with my cardiologis.  We agreed to 200 mg daily (half the original dose) and for just 2 months.  I fortunately did not experience any of the listed symptoms.  Were I to return to a-fib, I will request a different medication.  (However, my circumstances were much different than yours)

[Lil711]

I was put on amiodarone in the hospital after open heart surgery when I developed afib, and then took it for a total of 2 months. I really made an effort to lower the dose of it as quickly as possible due to potential side effects. What is bothering me is that now, nearly 2 months after stopping the amiodarone, I still am suffering from tremor-like feelings throughout my arms and legs and anxiety that is worse on some days than other. It is a different kind of anxiety than I have had in the past and feels neurological, and I really think it has something to do with long term side effects of amiodarone, which  stays in the body up to six months after you stop using it and has additional side effects when taken along with statins and/or coumadin, both of which I was taking. So I do not think you are far off in your thoughts about amiodarone.
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[Ryker]

I got so sick on it that my cardiologist took me off of it at one month instead of the three months originally perscribed. I felt like someone who is on chemo must feel. It was constantly triggering my gag reflex making me feel like I was going to throw up and my anxiety was almost unbearable.

I've been off of it two weeks now, and fingers crossed, the symptoms are starting to subside.. If it hadn't been for the side effects of this drug, I would have been over the surgery very quickly.

There has to be something better than this drug for post-op heart bypass. I don't think the FDA even approves it for that purpose.