Amiodarene

Amiodarone side effects

by Julros - 2023-09-21 11:37:00

My sister was prescribed amiodarone last year for a fib. She is already on thyroid replacement and felt a change within two weeks. She subsequently needed dosage adjustments twice. The nurse practicioner who started her on it did not do pulmonary testing before starting. He ordered it later, and by the time she could get it done, it showed decreased lung capacity. She was told that may have been present before she started. All her other labs stayed normal. 

She had a cardioversion 2 months after starting it that only lasted 1 week. She has since be taken off it and her doctor may try sotalol. 

Amiodatene

by Happygirl8 - 2023-09-21 11:53:25

Do you know what dosage she was on? How much was she taking? 

Amiodarone

by Gemita - 2023-09-21 13:03:00

My mother was on Amiodarone for 2-3 months at a daily dose of 200 mg.   

The problem is that Amiodarone is one of the most effective anti arrhythmic meds out there to help prevent an arrhythmia but it needs close follow up and frequent health checks.  Unfortunately my mother developed respiratory distress while taking it and went into respiratory failure.  It is hard to know whether Amiodarone was the culprit.  I suspect it didn’t help.

I don’t know how best to advise you because Ventricular Tachycardia clearly needs controlling, although I don’t feel that a potentially one off VT episode which caused syncope in August would necessarily see me rushing to take Amiodarone.  Once you start a powerful medication like Amiodarone, in my experience, you might need to stay on it long term since if you need to stop it, your symptoms (arrhythmias) could well return. 

Have you asked whether you could try another medication, perhaps something less toxic as a preventative med?  Oh what a predicament and I wish I knew how best to advise you.  You have an ICD, so you do have some protection should VT re-occur, so it is not as though you have not taken urgent steps already to treat your condition

Amiodarene

by Happygirl8 - 2023-09-21 13:53:49

Thank you Gemita.  How long was your mother on it and what dosage! Did she have respiratory problems before taking it? I have to go for a PFT before I start taking it. 

Amiodarone

by Gemita - 2023-09-21 14:25:40

Happygirl8, Mum had heart disease, but no respiratory problems before Amiodarone. She developed pneumonia while on Amiodarone and deteriorated rapidly.   Her GP was instructed to take her off Amiodarone at 3 months.  As already mentioned, Mum was taking 200 mg Amiodarone daily for 2-3 months.

I am glad you will be getting a Pulmonary Function Test before your start treatment.  As long as you are watched closely, they should be able to keep you safe (at least that is what my EP told me) when he offered me Amiodarone.  I declined, chosing Flecainide, Digoxin and Bisoprolol instead.  I have now weaned myself off all meds except low dose Bisoprolol, with great success. 

Amiodarene

by Happygirl8 - 2023-09-21 14:48:40

I asked if I can stop the pill if I develop side effects.  The answer was yes. Im concerned about blood pressure going too low and dizziness.  If that occurs, I was told I can stop taking it.  Did your mum have a PFT before taking it? 

No

by Gemita - 2023-09-21 15:02:11

No I don’t believe she received a "complete" pulmonary function test prior to starting Amiodarone although she had lots of other tests, CT Scan + bloods.  She was 80 at the time with extensive heart disease and they felt she needed help for that to try to stop her Atrial Fibrillation, which Amiodarone successfully did.  I think for older folks they are less concerned about longevity and more concerned about treating any acute symptoms to provide relief.

That is good that you can stop taking the med if it causes dizziness or other symptoms.  My only fear is whether you would then trigger a sudden VT episode after starting and then suddenly stopping this anti arrhythmic med  

Amiodarene

by Happygirl8 - 2023-09-21 16:11:52

I asked that question. I asked if I stopped the drug do I need to wean off if it and could it cause another episode? He said,  I don't need to wean off if it and if I stop taking it, it is not known to cause another VT episode . I feel like he feels he needs to do something.   I'm already on valsartan, amlodepine and a beta blocker carviderol, and he keeps  saying I've had 2 V tach episodes this year, one in March and one in august ( after defibulater insertion) I think he feels he has to go this route? He told me he doesn't want me to have another episode. He's trying to prevent it? I guess! He did say the final decision is mine. 

sorry, missed your additional "added" comments

by Gemita - 2023-09-22 06:35:53

Happygirl, your additional comments 

"I feel like he feels he needs to do something. I'm already on valsartan, amlodepine and a beta blocker carviderol, and he keeps  saying I've had 2 V tach episodes this year, one in March and one in august ( after defibulater insertion) I think he feels he has to go this route? He told me he doesn't want me to have another episode. He's trying to prevent it? I guess! He did say the final decision is mine"

I feel this too, but you are doing something and quite a lot.  Sometimes the more we throw at arrhythmias, the more they may progress.  From your comments you are feeling well for the most part, so why push for more?  

My doctors didn't want to take the sledgehammer out for my arrhythmias, explaining that by having an ablation, increasing my anti arrhythmic meds,  could make matters worse.  Arrhythmias can be exceedingly difficult to stop "altogether" which is why you were given your ICD.  If you were so symptomatic that your VT was really affecting your daily life, then that would be completely different, but you are not, as far as I can see, frequently affected by VT and you have the ultimate treatment/control already in place in any event - your defibrillator and any anti tachycardia pacing therapies.  

In your shoes I would probably want to wait, study what might be a trigger and work with this first, in the knowledge that you will remain safe with your ICD.  Should your VT episodes increase in the future, then you can take additional steps like starting Amiodarone or moving towards an ablation but you are on some good meds already and with your ICD I would feel more than protected.  But the decision as your EP says, is yours and it has to "feel" right for you 

Amiodarene

by Happygirl8 - 2023-09-22 09:28:42

Thank you Gemita, I tend to feel the same way as you! That's why I'm taking this slowly! I have an appointment soon, I think i may request another echocardiogram to see if there's been any change in my EF after that episode in august.  That will help me make a decision. If there's been no change and I remain episode free, I may not go forward with another pill at this time.