amiodarone question

Hi I just read Brooke's question to Eric about amiodarone and I am concerned.  I have posted earlier about my irregular beats and just saw my family doctor yesterday and he explained that my problem was PAC's instead of the PVC's I thought I had which made me feel some better.  He said that because they were annoying  he would give me a medication that would help and it was amiodarone.  After reading about it I was very concerned because it had so many side effects and so when I read that it was usually used as a last resort I was just wondering if it would be better if I didn't take it.  I am so confused.  Can someone help.

[Brooke_38]

Hello...

Confused and very concerned is an understatement! Given what you have been told to take for simple PAC's. Please tell me that you will be getting a second opinion regarding this. Preferably from a Cardiologist...Let me say this, I have been on just about every cardiac drug under the sun for management of things more serious than PAC's...At no time has my cardiologist ever suggested this to me as an option. He has mentioned the drug, but said that because of what you read in regard to the side effects, some irreversible, he would not consider this as an option.  

This medicine is an antiarrhythmic used for treating life-threatening recurrent heart rhythm disturbances in patients who cannot tolerate or do not respond well to other medicines. This drug is typically NEVER given for management of benign PAC's.

Do you have any other cardiac related problems or is it just what you mentioned in your question here (PAC's?)

The following comes directly from my Nurses Drug Guide, my bible at work:

"Before Using This Medicine: WARNING: THIS MEDICINE SHOULD ONLY BE USED IN PATIENTS WITH LIFE-THREATENING IRREGULAR HEARTBEAT. Worsening of irregular heartbeat, life-threatening lung disease, and serious liver problems may occur with use of this medicine. Alternative medicines should be tried before this medicine is used. Initial use of this medicine requires close monitoring and dose selection may be difficult. It is very common to require a dosage decrease or discontinuation of treatment. The recurrence of the irregular heartbeat after discontinuation or dosage adjustment is unpredictable and hospitalization may be required."

[fe41]

My doctor put me on Amiodarone last December when I started having skipped heartbeats. My PVCs started during the holidays last year and before I could get my EKG and Echo tests, I started having the PVCs so often (3-4 times per minute) that I was on the verge of panic. My doctor said I might suffer a stroke and recommended Amiodarone  (200mg). I started taking the tablets three times a day for a week, then twice a day for the next week, then once a day for the third week then twice a week after that. Then he told me I should maintain a once a week dose after that until my PVCs went away. Well, I am off it now not because my PVCs went away completely (I still get them everyday) but because all my tests came back normal. Since I have already started the Amiodarone before my tests,  my doctor cannot take me off it at once so I followed the tapered dose recommendation. I got scared when I researched the Internet and found that this drug has so many side effects and should only be used for life threatening situations. Thank God I was able to stop it on time before it caused further damage to my body. To tell you the truth, I don't think the Amiodarone was a big help for me because it did not stop my PVCs even after three weeks of taking it and know what, when I read about the bad side effects of the drug, the more I became anxious and scared thus, the more PVCs I got!  When I was finally off the drug and all my tests came out okay, I started to relax and not be afraid anymore. My PVCs became rare although as I said before I still get them once in a while but now I try to ignore them because I know they are benign and they won't kill me. I also got support and reassurances from other members of this wonderful Medhelp Community which I was so glad I joined. Take care!

[Rudy777]

Hi L,
Ask your doctor if he/she would prescribe that med for you if you were 50 years old? Or 30 years old?
I am having the same doubts about Quinnidine as you would see in my post but some of these last resort type meds have cumulative toxicity so over time side effects could get more prominent or more pronounced.
This is not an answer but it coud open the conversation with the Dr. for the better for both of you.
Good luck and keep looking

Rudy

[grendslori]

Amiodarone is usually the LAST drug used to treat life threatening arrhythmias. I am shocked this doctor ordered it for PACs and chose it as a 1st drug of choice. Amiodarone has a long 1/2 life and can be found in the body for up to a year AFTER it has been stopped. It can cause problems with the thyroid (hypothyroidism) as well as Restrictive Lung Disease (fibrosis of the lungs) It can also lead to severe burns to the skin, much worse than the average BAD sunburn, even on cloudy days! It can also turn the skin blue in color, which, from my understanding, can be permanent. It can cause liver problems as well as cancers. The list goes on and on. Get off of this drug if you can! Maybe your doctor could prescribe Inderal?  

[Bilbo1933]

Your concerns about Amioderone are well founded based upon the literature.  I will tell you this, I am a drug rep and call on hospital ICU units and Amidoderone is used all the time for post operative afib.  I try to convince them to use my drug instead, but many of them, especially the caridac surgeons and intensivists love amioderone.  Cardiologist tend to prefer beta blockers.  That being said, I have Afib and have had 3 ablations with no total positive result.  I was on amioderone for over a year.  It did not work for me.  The side effect that I encountered was the hyper sensitivity to sunlight.  Looked like I had a sun burn year round.  Then in the summer at the beach, it really kicked in even though I took every precaution to stay out of the sun.  Although my afib issue is not resolved, I am glad to be off amioderone.  Hope that helps and good luck.

[Sweetwaterguy]

   I am one that experienced side effects from amiodarone.   It was prescribed following my ablation and was always intended to be used only during the healing period.   I developed tremors, most notibly in my hands.  My handwriting has always been poor, but while on the drug, it became extremely difficult to write a check and even sign my name.  The doctor allowed me to quit taking it a month earlier than I ordinarily would had I had no side effects.  Amiodarone has a long half life and it took quite a while to withdraw and for the symptoms to abate.  With regard to side effects, I did experience them.  Most people do not.  
    However, not being a physician I do not wish to offer medical advice.  I agree your concerns are significant, and I do think it is appropriate to see a cardiologist for a second opinion.  

[Hopeful39]

I had a single event a-fib almost a year ago.  I was given IV Amiodarone which successfuly converted me back to sinus rythm.  I was then on oral dosage.  Cardiologist initially said 600 mg per day for 3 months.  After I researched it and discovered the same information discused above, I negotiated with my cardiologist down to 2 months with only 400 mg per day.  Although the medication was successful in conversion, I do not know if it prevented another occurence or not.  I no longer take it and did not realize any significant side effects.  

I recommend that you discuss with your Cardiologist (or EP), do not just stop taking the medication without the advice of your doc.  The second opinion is important.  

You will find in your research, that although the drug is approved by the FDA as a 'last resort', the majority of use and prescriptions (over 75%) are off label with a large number related to a-fib issues (like mine).  

Best wished.