Stopping Amiodarone treatment for AFIB after AV replacement

[bdryer]

I developed AFIB after AV replacement, which is common. The AFIB is considered temporary. To correct the AFIB I was placed on Amiodarone for 3 mths. I'm 20 days into the period with no sign of AFIB. The dose is 200 mg daily.

Saw my cardiologist today and he spelled out how bad Amiodarone is for the liver, thyroid, lungs,eyes and skin. He wants me off of it over the next week. I was told that the Amiodarone has a long 1/2 life and will be in my system for a month or more.

I also take 100 mg of Metoprolol twice daily. He said if the AFIB returns bump up the Metoprolol by 50 mg. He said if required I can bump it up to 400 mg per day. We have a plan.

I'm considering after 20 days of treatment getting off this horrible drug now.

For those of you who developed temporary AFIB after AV replacement and were treated with Amiodarone, how long were you on the drug for?

Thanks

 

[ks1490]

I was on Amiodarone to control Afib before my surgery for about 9 months. I then had the Maze procedure at the same time as my AV replacement to address Afib permanently (hopefully!). To deal with post-surgery a-fib, my cardio put me on Multaq (dronedarone), which is considered the "son" of Amiodarone, without the side effects. Having said that, I have been monitored by a thyroid specialist, my gp and my eye doctor throughout and none of them found any negative effects of the Amiodarone - you have to be on it in size and for a long time for those nasty side effects to really have an impact.

 

[New Guy]

bdryer,

I had afib 2 weeks post-op and was put on Multaq for 6 months. Off it now for over 2 months and so far good news. The Multaq is supposed to come with fewer side effects but it's still a new to market drug and had some bad press recently. I just did a quick search for that story but didn't find it.

It's all worked out well for me so far and I'll hope it will for you too.

 

[zipper2]

Bdryer,congrats on your surgery and recovery here.
I was on this also i had a maze done 2009 along with native mitral to mech one
my posts are gone now but i was on it if i recall month to 6 weeks
my cardio hated the drug also and it was my surgeon that put me on it.
after my maze they cardioverted me 3 dif occasions then it kicked in but i was
put on the amirodone for sometime after that my cardio removed me and i had to
go get lungs,eyes whatever he wanted checked at request.
I too was told it stays in your system a month after stopping it and i thought
this sucks to remedy your afib gotta threaten other parts of system.i was sick
to the tummy takin it and lost alota weight but it hadn,t harmed other areas of
my system.Watch coumadin it liked to increase my inr and watch inr coming off the
amirodone too.Im sure you,ll be fine on it for short duration

 

[Jason]

Bdryer, I too had atrial flutter 2 weeks post op, and as you say it is fairly common especially for people who get aortic valves. The cardio on call when I was readmitted to the hospital put me on a large dose of Amiodarone for five days to get the drug onboard, (400mg twice daily) after which I have been on 200mg/day since. He never told me at the time how long I would be on it, but did indeed say it would be a short-term drug. The prescription I got would last me for one month, and it had no refills on it.

I am hoping that when I go into see my full time cardio on Monday they will wean me off of it too. I am not a Doc and this is by no means scientific reasoning for stopping the drug, but for two weeks after I was on Amiodorone I was still getting skipped beats, and then compensatory beats, when I laid down. It also happened a few times while I was sitting up. That being said, I know that I havent' had a bout of this skipping heart beat for at least a week, and I think coming up on two weeks. My heart feels 'stronger' when I lay down, and I am hoping this means my natural pacemaker is taking over and I may be able to get off of the Amiodorone. I certainly like the fact that it stopped the atrial flutter, and I hope that I don't get that ever again. However, the side affects of Amiodarone certainly makes me nervous. Also, the Amiodarone just hammers my stomach if I haven't eaten prior, or eaten enough.

As someone mentioned above, make sure you GP/INR clinic knows about you coming off of Amiodorone and watches you closely. The Amiodorone does affect the numbers, and can have an affect for up to a few weeks depending on your liver function.

Good luck, and I hope Monday has similar news for me WITH no more atrial flutter.

 

[bdryer]

Hi gang

My experience with Amiodarone stopping the AFIB was amazing. The AFIB stopped as soon as they started the oral loading phase, [thank God they did NOT do an IV drip]. I am absolutely terrified of it's side effects. I did a search on our site and as New Guy experienced, Multaq is a desired alternative. Apparently, elementally, Multaq is Amiodarone without Iodine. I'm not certain why my cardiologist did not select Multaq as a bridging alternative. Rather he said stop Amiodarone over the weekend, resume it mid week and go cold turkey starting next week end. If the AFIB returns bump up the Metoprolol by 50 mg. I so want to start going cold turkey now, especially with the understanding that the Amiodarone remains in the system for 1 mth plus.

 

[Jkm7]

Do what your doctor said. He has very much more knowledge and training than us. He was most specific about the pattern he wants you to use getting off the drug. I wouldn't dream of varying from his instructions. A week or less more dose of amiodarone is not going to change anything in terms of side effects. If you were talking a month or more, maybe, but not a few more doses.

Good luck.
Let us know how it goes.

 

[Johan]

I was on Amiodarone for about 60 days post op, 200mg per day, when I started developing strange vision disturbances in my left eye. It was like a low lying purple cloud with the typical outline of a low cloud covering about half of only my left eye. When closing the eye the cloud formation remained but changed colour to a sort of steel grey. This would last for about 10 mimutes and then slowly dissapear. Went to see the opthalmologist and he said there was very mild damage to the retina caused by drying of the fluid in the eye. Very scary. He did not know much about amiodarone but after I mentioned that it had al sorts of side effects he called my cardio and surgeon. All my docs then agreed that I should come of the Amiodarone ASAP. Went off it cold turkey. Did that as I say after 2 months. Had this vision thing on and off for about a month after, then it disappeared. Also no more A-fib.

I am now nearly 2 years post op and totally back to normal. Strange thing is, about a week ago I had the same vision thing in the left eye. Looked exactly the same and again lasted for about 10 minutes. This happened twice. Did not tell docs about it yet, shall do next week when I have my 6 monthly checkup with the cardio. There cannot be any more amiodarone in my system but the damage seems to be still there. Yes seems this Amiodarone is dangerous stuff.

All the best for your further bumpfree recovery!

 

[Lynlw]

There are quite a few threads about Amiodarone and the side effects. IF you do a search here for sledgehammer many will come up.
The half life is VERY long, can last up to 6 months after you stop.

There are all kinds of warning about how it SHOULD be used as the med of last resort for Afib after the others don't work, because of how dangerous it is. But many doctors like to use it first because it works well

http://www.drugs.com/pro/amiodarone.html
has alot of info and the warning is in a yellow box

 

[Johan]

Lyn, thanks for the link.That was the sacariest piece of literature I have read in a long, long time!!

 

[bdryer]

Yeeeeea! Just got the call from the surgeon clearing me to punt the "drug from hell", or Amiodarone. First the cardiologist and now the surgeon have given me the go ahead to "deep 6 it". What a relief! Trying to stay calm so AFIB does not return, but needless to say I'm very "jacked".

I got a 20 day build up of Amiodarone to manage over it's 1/2 life so I'm going to have to be very careful with alcohol consumption, [like none], and sunlight exposure.

Thanks very much to all my brothers and sisters who contributed to this thread. Johan I hope your eye anomaly gets better!

 

[Greg a]

Bruce, I am still on the Metoprolol (150mg twice a day) but don't find too many problems with that

 

[epstns]

Bruce - Glad you've gotten rid of the bad stuff. I have appointments in the next couple of weeks to evaluate getting me off amiodarone, too. (crosses fingers, toes, eyes. . . )

 

[neil]

hey bruce......yep was on amiodrone for 3 month,seemed to do the trick.

 

[Jeff Edmonton]

Yes Bruce what Steve said, it is good to hear you are getting better and getting rid of the amiodarone. Take care bud and keep all the snow to the south where it belongs...No more bumps for us Crazy Cannucks.

We should go for a beer\coffee and watch the Royal Wedding on the 29th

 

[bdryer]

Hi Kids

Greg, I'm with you on the Metoprolol. This is the drug of choice for cardiac patients. On my second last day in the hospital, a good natured nurse entered our room and shouted "pop quiz", what's the #1 heart med. I said Amiodarone followed by Metoprolol. She said Metoprolol alone is the answer. For the time being I'm on 200 mg 2 times daily of Metoprolol. Cardiologist expects me to be off the drug in the future.

Steve and Neil. I'm thinking 3 mths is not a big issue if you take care of yourself while on Amiodarone, or do not have a pre existing condition. I'm glad to be done with it in 20 days. Unfortunately Johan is dealing with a purple haze after 60 days. We are truly all different.

Jeffy, when the heck is winter going to end in our home province? We had 23 cms day before yesterday and 5-10 forecast for tomorrow. Me Mr ski guy missing out on all that Rocky Mountain skiing out my back door. High over the next few days, like -1 or -2 C. Oh well, at least it forces me to cover up while the Amiodarone dissipates out of my system.

 

[bdryer]

Jeff

No getting emotional during the ceremony, OK big guy! Hey lets do this, only in England. We should stay at Neil's place and crash the wedding in his new Jag. Neil seriously, Jag or not, you are going to have to wear a shirt, other wise we will not be able to crash the Royal wedding. You cannot get in if you look like Onslow from "Keeping up appearances". LOL!

Greg a, see if you can conjure up a pic of Onslow driving one of his beaters!

 

[Cris N]

I was on amiodarone for a month. Saw the EP heart doc for checkup and he said no more. I was scared to death that I would have more trouble with heart rate - but no problems at all. Hope all goes well for you.

 

[Bina]

here you go....Onslow in all his glory !!

jeff

no getting emotional during the ceremony, ok big guy! Hey lets do this, only in england. We should stay at neil's place and crash the wedding in his new jag. Neil seriously, jag or not, you are going to have to wear a shirt, other wise we will not be able to crash the royal wedding. You cannot get in if you look like onslow from "keeping up appearances". Lol!

Greg a, see if you can conjure up a pic of onslow driving one of his beaters!

 

[bdryer]

Bina

HaHa! Well done!

Look out Royal wedding, the VR boys from Hull England and Alberta Canada are coming to town!