Evil Amiodarone

[TheGymGuy]

I think to make this into a fresher perspective my title should've been "Evil Amiodarone, or is it?"

Just as I got off this drug, I wanted to post up why I have been trying stop taking it so hard. Ok, Bill B might have had something to do with my research, but I wanted to share these links and hopefully others can add some links as well.

http://www.coyote-howls.com/ - a story of one guy who was on it and how it really did a number on his system
http://heartdisease.about.com/cs/arrhythmias/a/amiodarone.htm - just a general article. Overall, I enjoy about.com articles
http://www.nlm.nih.gov/medlineplus/druginfo/meds/a687009.html - drug description


Hope this was the right place to post this up.

 

[Ovie]

Not familiar with this drug, but I'll check out the sites.

 

[Bill B]

Not familiar with this drug, but I'll check out the sites.

That's fortunate. Although it works rather well for atrial fib, it is fraught with side effects, as those links explain. It's very presumptuous of me to question why Vadim was given amiodarone, but I do.

There are a number of studies showing that amiodarone can reduce the incidence of atrial fibrillation in OHS patients, and it's use for this has become popular in some centers and is especially popular in Europe. However, these studies were done largely in populations of elderly bypass patients, many of whom had multisystem disease. Not quite like Vadim. Also, these studies used just a short course (few days) of intravenous amiodarone, sometimes supplemented by a few days of oral drug. None of these studies involved continuing amiodarone for several weeks after discharge. Here's a relatively recent literature review.
http://www.cardiothoracicsurgery.org/content/5/1/121

Here are the most current guidelines for management of atrial fibrillation, including post-op prophylaxis (starting on page 67).
http://content.onlinejacc.org/cgi/reprint/57/11/e101.pdf

 

[marc_kowal]

I've been on Amiodarone since my surgery on March 5th due to some minor a-fib incidences. I have about 2 weeks of pills left which will put me at about the 8 week mark. According to my cardiologist, most people who experienced a-fib after surgery will usually be suceptible to a-fib for the next 6-8 weeks and that's why it is generally given.

 

[Sarah_Louise]

Just shows sometimes meds supposed to help can make situation worse,
Thanks for the information
Love Sarah xxx

 

[karla]

I was told that around 75% - 80% of AVR recipients developed afib at some point post-op. I had none while in the hospital but a few weeks after I got home, i was feeling pretty good and probably overdid the walking a little. My pulse was all over the place for a few minutes, then normal, then everywhere again and it persisted that way for about 24 hrs. I called the doc and he thought I was likely having little "bursts" of afib and increased my betablocker. I also took the walking easier for a few days. Problem solved like magic. I have not had any episodes since. Did not have amiodorone in or out of hospital.

 

[Lynlw]

I've been on Amiodarone since my surgery on March 5th due to some minor a-fib incidences. I have about 2 weeks of pills left which will put me at about the 8 week mark. According to my cardiologist, most people who experienced a-fib after surgery will usually be suceptible to a-fib for the next 6-8 weeks and that's why it is generally given.

Ihas a black box warning, that is should be the drug used as last resort, AFTER other med were tried and didn't work because of all the bast side effects and its long half life. Even after you stop it it will be in your system for months

 

[Greg a]

I was started on this in Jan 2012 and still am on 200mg once daily. I had to go onto it due to my ICD firing 4 times in 3 days. Being an Iodine based drug "Blue Man Syndrome" is one side effect that if I get it will confuse me as to if I grow a beard and rent myself out for children's partys as PAPA SMURF or join the musical whimsy called The Blue Man Group.......here is a link to blue man syndrome http://circ.ahajournals.org/content/113/5/e63.full the result of the iodine based drug

 

[TheGymGuy]

Greg, the summer is coming. If you should change color and do become Papa Smurf. Can I rent ya for my nephew's birthday party? You can be Papa Smurf and I will be one of the other random smurfs who is slightly less blue, but is very very angry.

One of the questions that I really do have is whether there is a way to calculate the half-life based on the amount and duration that you took this drug for?

 

[neil]

think its given a bad press at times,given in short sharp burst like i had it it seems to be ok and must say stopped my af,what my cardio told me it is not a good drug to be on long term but usually ok short, all drugs have side effects,

 

[mainframe]

I was given Amiodarone for a couple of months after I got home from surgery. I don't remember if I took it the 2 months I was in the hospital. My cardio seemed relieved when he told me to stop taking it. He said it was the nastiest stuff (most side effects) he could prescribe.

 

[Bill B]

Greg, the summer is coming. If you should change color and do become Papa Smurf. Can I rent ya for my nephew's birthday party? You can be Papa Smurf and I will be one of the other random smurfs who is slightly less blue, but is very very angry.

One of the questions that I really do have is whether there is a way to calculate the half-life based on the amount and duration that you took this drug for?

Amiodarone has very unusual pharmacokinetics. The half life of elimination is quite variable but extremely LOOOONG, somewhere between 10 and 120 days! Most drugs are a few hours to a few days at most. So, what this means is that half of the drug in your body at the end of treatment will still be there 10-120 days later as it slowly leaches out of the body fat, where it is stored, and is metabolized, and then another half of that is removed in another 10-120 days. Crazy! Now, even though you took it for 3 weeks, you did not get a whole lot. For this drug to work quickly, you either need a good IV dose or much higher oral doses (800-1600mg/day for the first week or so).

 

[Greg a]

I was started on this in Jan 2012 and still am on 200mg once daily. I had to go onto it due to my ICD firing 4 times in 3 days. Being an Iodine based drug "Blue Man Syndrome" is one side effect that if I get it will confuse me as to if I grow a beard and rent myself out for children's partys as PAPA SMURF or join the musical whimsy called The Blue Man Group.......here is a link to blue man syndrome http://circ.ahajournals.org/content/113/5/e63.full the result of the iodine based drug

 

[TheGymGuy]

Hmmmm.... Seems like loosing fat and/or getting body fat way, way down could get this drug out of the system faster for those that are on it for a long time. I mean, once they are off of it, or maybe have some weird symptoms one way to speed up loosing it would be to loose a bunch of adipose tissues. I know that it is also stored in other tissues of the body like kidney, liver and lungs, and for those time might be the only thing, but with fat tissue at least there is some control we have.

 

[TheGymGuy]

more pictures of papa smurfs

more pictures of papa smurfs

Greg,
I could not resist some of these.

pic1: Papa Smurf. pic2: Bloomberg Smurf, and pic3: a Musical Papa Smurf, do ya play an instrument?

 

[Bill B]

Although it goes to many organs, it moves in and out of them pretty quickly. Fat is where it's at for the long haul. Whether losing fat weight or having little to begin with helps reduce the total load hasn't been studied. It's one bizarre drug. There are others that are stored in fat, but amiodarone is an extreme case. And the side effects are extreme, like the blue man effect. The pulmonary toxicity is the one that scares me as it can come on during short courses and can be nasty when not identified quickly. It has so many effects beyond its antiarrhythmic action, that it can cause almost anything to happen. It affects blood pressure (it was first developed as a vasodilator), cardiac function (heart rate and contractility), thyroid, liver, lung, you name it.

 

[TheGymGuy]

Thanks for your explanation Bill. I suppose, as an experiment, we would need to find someone that had some effects from it and train (and, diet) them into low/single bodyfat figures once they are off of it and see if that makes it leave their body faster. Of course, we would need to be able to measure how much of that stuff is still in their body, but that is a totally different story.

Thanks all for your responses.

 

[Bryan B]

I am like a lot of others who was on amiodarone short term after my first surgery. When the surgeon "started me back up" in the OR I immediately went into a-fib so he started me on an intravenous drip. Once out of ICU that was stopped and I was on an oral dose for the rest of my hospital stay and 4 weeks at home. I never did have another bout of a-fib after the one in the OR so I guess the drug worked for me. Fast forward and in the summer of 2010 I went into a constant state of a-flutter. They discussed sotalol but decided on cardioversion. That was aborted due to a blood clot in my heart, so after 6 weeks on coumadin I went back into the hospital and they decided to do a catheter ablation which has worked wonderfully. It seems with all of the options available today to treat a-fib/flutter that they could get rid of amiodarone except for emergent cases.

 

[marc_kowal]

Also keep in mind how many mgs/day you are taking. In my case, I've only been on 200 mg per day, which is considered to be a low dose. I know a lot of people are on a much higher dose for a lot longer, those are the people who need to be cautious.

 

[Luana]

I was given amiodarone in the hospital post AVR for afib. I knew nothing about the drug at the time.

After I came home, and read about it, I wasn't real thrilled about possible side effects, particularly the pulmonary stuff. I told cardiologist I would take it for 30 days. I did and stopped promptly on day 31. It also can mess with INR.