Need an alternative to amiodarone

[worship.dr]

Hi Guys,

I am new to the board. I am in week 8 following an ascending aortic anurysm repair and an aortic valve replacement. I have several questions but only time for one today. I developed post operative A-fib right after the surgery but it stabilized before I left the hospital. It returned around week 4 and my doctors put me on amiodarone. I was having several A-fib attacks a day of short duration. With the amiodarone A-fibs have almost completely subsided, but I am very concerned about the plethora of dangerous side effects. I have an appointment at the end of the week and I want to talk to my cardiologist about alternative meds. Suggestions from the gallery?

 

[Lynlw]

Welcome. There are a few meds that are safer than amiodrone, that should be used AFTER all other meds didn't work because of all the possible side effects.
I would suggest you do a search here for multaq. it is basically amiodrone without the iodine and bad side effects.

 

[kfay]

Are they talking about keeping you on it long term? A lot of us were sent home on it from the hospital for "short" term use, mine was 3 months. Your heart is just reacting to what was done to it. Hopefully, after a couple of months, it will calm down. If not, there are certainly drugs that have much less side effects and eventually, you may even be a canidate for an ablation if the a-fib continues long term.

 

[hensylee]

yes, there are others. And they should be used before this dangerous one. Hoping you are able to get your doctor to explore for a good one.

 

[Ross]

Multaq, Betapace, and one other that eludes me at the moment.

 

[nngbwh]

Just want to welcome you the the VR family.

 

[Jkm7]

There are some here on VR.org who have been prescribed sotalol. Some seem to have responded well to it.

Let us know what your doctor says.
Best wishes.

 

[Bina]

Sotalol (Betapace) seems to be a good one.
http://www.medicinenet.com/sotalol-oral/article.htm

 

[ALCapshaw2]

SOTALOL is the Generic Form of BetaPace and is used by several of our members with good results controlling A-Fib with few side effects. It is recommended to be started while hospitalized 'just in case' any dangerous arrhythmias are triggered as the body adjusts to the medication. Many Drug Stores sell it for $4 for 30 tablets or $10 for 90 tablets/.

Multaq is a Newly Approved alternative to Amiodarone which is similar in design without the Iodine component as previously mentioned. I expect it is rather expensive.

'AL Capshaw'

 

[sylviayasgur]

hi worship.dr,
my husband is the patient here. 4 days after his surgery, he went into afib. he had been taking betapace (sotalol) preventatively pre-surgery, but when they administered it post-surgery, it did not work. they then gave him magnesium drip and amiodarone. he has been afib free as long as he takes the amio. each time he tries to wean off the amio, he goes into afib. we have been consulting with an arrhythmia specialist at montefiore hospital in ny and he has suggested joey stop the amio altogether. amiodarone accumulates in your body fat, and has a long half life. this means that once you stop taking it, it takes over a month to completely leave your body. so, joey stopped taking it about 3 weeks ago and has still not gone into afib. we anticipate this should happen over the next week or so.
he is scheduled to start taking multaq ("amiodarone- lite") in a week. the multaq, unlike the amio, is water soluble and leaves your body when you stop taking it. you take it twice a day. we're hoping that this will do the trick.
if not, joey will have to be hospitalized in order to try another med, tykonin. hopefully, one of these two will do the trick. keeping our fingers crossed.
i will keep you posted. i hope this helps. please let me know if i can help in any other way.
be well,
sylvia

 

[Jeanie]

I understand your concern on Amiodarone; I was quite freaked out at its potential side effects. FWIW, here is my experience with it. Following surgery for a few weeks, because I had been in such poor shape before it with both stenosed Aortic valve and CHF, I had more trouble with the drug than later on. In fact, I stopped the drug myself after 2 weeks (prematurely as it turned out), only to have to go back to hospital for cardioversion due to A-Fib. This time when they put me back on it, more information was provided to me, that made me more accepting of it. One was that the intention was to have me take it no more than 3 months. Another was that the really severe side effects normally only are seen in those who take it long term. Last but not least, they did encourage me to tough it out for a while longer and a promise they would discontinue it as soon as possible or if any serious side effects appeared.

Also, the surgeon explained that the reason arrythmias are such a common problem after surgery is disruption of the nerve conduction process. The good news is, my surgery was January 14th. I was told I could stop Amiodarone after my March 26 dose. (I had reported concern over side effects that I was seeing, that my feet were turning grayish purple, and that I had a return of the eye pain I'd had in the hospital presumably from that drug, and some possible thyroid issues.) The cardiologist promptly scheduled me for complete blood work including thyroid when I reported those problems, and I have a hunch that clarified for Doctor that I was not imagining some thyroid changes. I had another echo done too, March 16 same day as the blood work, and that showed good improvement. I am sure those things influenced decision that it was OK to stop it. Now just 2 weeks after stopping the drug, even though it may take another couple of months for it to totally clear my system, my feet look normal and the extremely flaky dry skin is improving. The only drugs I am on now are anticoagulant and a Beta Blocker Metoprolol (dosage was just reduced on that one this past week.) I hope that helps, but of course the standard disclaimer applies that 'your mileage may vary'.

 

[debster913]

I'm on Multaq and haven't had any really bad side effects. It made me a little dizzy in the beginning, and if I forget to take it with food I get nauseated, but other than that I feel pretty good on it.

 

[sylviayasgur]

hi debi,
that's great news! i hope joey does well on the multaq. he started taking it two days ago. stopped the amio a month before that.
he'd been on a scant dose of the amio for years and despite the fact that all the drs said it wasn't big enough a dose to really do any damage, his lung capacity has diminished marginally and he has retinal deposits from the amio. he takes synthroid (thyroid meds) and i'm curious to see how being off amio will affect that as well.
i'm hopeful but don't want to get excited too soon. i'm just glad he was finally willing to try an alternative and this new dr agreed it was worth a try.
keep your fingers crossed for us!!!
will keep you all posted.
be well, sylvia

 

[tcopel]

My EP put me on Tikasyn after my third bout of a fib after my surgery.

 

[karen14]

Welcome to the forum worshipdr!

 

[sylviayasgur]

tcopel,
how is it going on the tykosin?
joey has been on multaq for a few weeks, but the doc is giving him only 2 more to decide whether to abandon multaq and try the tykosin, since he has been experiencing some afib almost every day. doc's convinced that if the multaq was doing its job, joey would not be having any afib.
if it does not improve, then they want to try hospitalizing joey and trying tykosin.
has it been working for you? what are some of the side effects you might be experiencing?
hope you're doing well,
sylvia

 

[Ruth]

I'm sorry that I ever took Amioderone. At 2 weeks post op I developed persistant (continuous 24/7) AFib. I took Amioderone for 3 months hoping that it would stop the AFib and allow me to avoid a cardioverson. The Amioderone had absolutely no effect whatsoever on the AFib, didn't cause it to relent, not for a minute. At least if you're going to suffer the consequences of this "big gun, last resort" drug it would be nice if it at least worked. It sure didn't for me. I just felt sick every day I was on it. It did do a pretty effective job of throwing my thyroid gland out of whack and I now take thyroid meds to this day.

I've also learned that there is a direct relationship between proper levels of thyroid hormones (in my case supplements) and heart rhythm. I would suggest that anyone with rhythm issues ask their Dr. if a full thyroid screen including Free T3/T4 might be appropriate for them.

The good news in all this is, after 3 solid months of post op AFib, after the cardioversion on 3/15/07 I have been in normal sinus rhythm since then (knock on wood). Go figure.

I wish you all the best,
Ruth