amiodarone formula

According to the FDA, “Amiodarone is intended for use only in patients with the indicated life-threatening arrhythmias because its use is accompanied by substantial toxicity.” The FDA goes on to state that “Amiodarone has several potentially fatal toxicities…” They include lung toxicity, worsening heart rhythm disturbances and liver injury. The drug must be handled with kid gloves. Amiodarone side effects are not the only problem. This drug can interact dangerously with many other medications. That is why one reader sent us this question:

Amiodarone Drug Interactions:

Q. I frequently read your warnings that there may be interactions among medicines. Two doctors prescribe medications for me: my primary care doctor and my cardiologist. Although I ask, I don’t think either of them is very concerned about possible interactions. What can you tell me about metformin and glipizide for diabetes, along with Eliquis, amiodarone, ramipril, simvastatin and tamsulosin?

A. You are wise to be concerned. Many of your medications could interact with each other. The heart drug amiodarone could increase levels of simvastatin in your system. That could magnify the risk of muscle damage. Amiodarone can also increase levels of your prostate drug tamsulosin, which could lead to adverse reactions.

Ask your cardiologist about the potential for amiodarone to interact with the anticoagulant Eliquis (apixaban). Your pharmacist should also review all your medications for possible interactions.

Drug Interactions Deserve Scrutiny:

If in fact this person’s physicians are not being careful about interactions with amiodarone, they are making a big mistake. Other medicines can affect the electrocardiogram to produce what is known as a long QT interval. These drugs include lithium, tricyclic antidepressants like amitriptyline, fluoroquinolone antibiotics such as levofloxacine (Levaquin), macrolide antibiotics like erythromycin and clarithromycin and the pain reliever tramadol.

Statin-type cholesterol-lowering drugs can also be affected. We are especially concerned about simvastatin, lovastatin and atorvastatin. Anyone taking amiodarone must double-check to make sure there are no dangerous or deadly drug interactions.

Amiodarone Side Effects:

We have not listed all the potential amiodarone side effects in the table below. That’s because such lists are mind numbing. After the first couple of adverse reactions most people zone out. Here are a few key concerns:

Signs and Symptoms to Watch Out For:

  • Shortness of breath, wheezing, difficulty breathing, coughing. Any such symptoms could be signs of lung toxicity!
  • Hepatitis, jaundice, liver enzyme abnormalities
  • Heart rhythm changes
  • Thyroid dysfunction (diverse symptoms from hypo to hyperthyroidism)
  • Exhaustion, fatigue, unsteadiness, dizziness
  • Hand shaking, tremor
  • Digestive upset, nausea, vomiting
  • Skin rash

To learn more, visit this link:

Amiodarone Side Effects Can Be Life Threatening

Readers Share Stories:

It is often meaningless to provide a long list of side effects or symptoms. Drug companies know this. That is why the announcer can speed through a long list of scary side effects during a prescription drug commercial and no one seems to blink. Ditto for print ads. If you see a long paragraph with 30 side effects your brain tunes out pretty fast. That is why we share real stores from real readers:

Linda W. in Bragg Creek, Alberta, Canada writes:

“I had most of the most debilitating side-effects (nausea, anorexia, constipation, weight loss, blurred vision, fatigue, depression…). It was a horror for me, to the point where I felt suicidal. The worst part was that none of my specialists took my complaints seriously, especially the cardiologists.

“I white-knuckled it for 8 months while awaiting the catheter ablation. I still feel nauseous and weak 2 months after stopping, only to find that serious side-effects due to internal organs toxicity may occur up to a few years after ceasing usage due to its storage in fatty tissue, especially the liver.”

Pulmonary Fibrosis:

Betsy shared this story about a serious amiodarone side effect:

“In January 2010 my husband had a quadruple coronary bypass surgery which was completely successful. He came out of the hospital taking several drugs, one of which was amiodarone, even tho at that point he was no longer having atrial fibrillation which he had immediately after surgery for several hours.

“A few weeks later he began having shortness of breath, lung x-rays showed inflammation which was diagnosed as pneumonia and treated with various antibiotics, with no relief.

“Finally in May the pulmonologist said to himself, while studying the x-rays, ‘Maybe it’s the amiodarone.’ That was the first time anyone had mentioned anything about it. So I looked it up and sent the cardiologist an email saying we were discontinuing it. His response–’I agree.’

“Too late. He developed pulmonary fibrosis and he died four years later, on oxygen the whole time, weighing 90 lbs at the end.”

Myrtle in Maryland also had pulmonary fibrosis:

“In July 2016 I was sent to Johns Hopkins [JH] hospital in Baltimore for a triple by-pass. After a week of terrible pain I then was in re-hab for several months. The doctor who sent me to JH put me on amiodarone. After staying on amiodarone for 6 months I called doctor’s office and expressed my concern on staying on the med so long. was told to ‘talk to the doctor when I come in for next appointment.’

“By February of 2017 I could hardly breathe. After a 7-day hospital stay they decided that I had pulmonary fibrosis – the pulmonologist and my primary care physician both believe the amiodarone caused it.

“The result is that I am on oxygen 24/7. It’s heartbreaking to have this happen. I feel like my cardiologist betrayed me.”

People’s Pharmacy Perspective:

For some people amiodarone is a life saver. No one should EVER stop a prescribed medicine without careful discussion with the prescribing physician. That said, amiodarone requires VERY careful oversight. At the first sign of lung problems a patient must be thoroughly monitored.

In our opinion, amiodarone should only be prescribed by a physician who promises to: 1) stay well informed about amiodarone side effects and drug interactions. 2) knows how to monitor patients for adverse reactions. 3) Avoids unapproved indications unless as a last resort.

The only FDA approved indications for amiodarone are:

1. Recurrent ventricular fibrillation

2. Recurrent hemodynamically unstable ventricular tachycardia

Please note that atrial fibrillation is not on that list.

Share your own experience with amiodarone below in the comment section.

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  1. Charles Koster
    N C
    Reply

    Amiodarone seems to be the go to miracle drug for cardiologists.

    I was on 4 years before I insisted to be taken off. My doctors never looked into other factors and hazards of this drug. I’ve been off for two months. In the 4 years my breathing became worse had cataract surgery and problems involving my kidneys and liver Coincidence maybe but I doubt it. These doctors are overworked and could not care about the individual.

  2. Charles K
    N C
    Reply

    Amiadarone seems to be the go to miracle drug for cardiologists
    I was on 4 years before I insisted to be taken off

    My doctors never looked into other factors and hazards of this drug. I’ve been off for two months. In the 4 years my breathing became worse had cataract surgery and problems involving my kidneys and liver Coincidence maybe but I doubt it. These doctors are overworked and could not care about the individual.

  3. Jim
    Kentucky
    Reply

    I had a history of palpatations but one day I kept getting them and felt a little woozy. Wife insisted I go to emergency room where they found I was in a-fib. Never knew I had it! Treated me with Amiodorone which stopped it in 20 minutes. Was put on an oral dose of 800 mg for 2 weeks, then 600 mg for 2 weeks down to 200 mg as a “maintenance dose”. During this time I experienced bad headaches, sore throat, violent dreams (when I could manage to sleep!) and numerous other side effects. When I reached 200 mg. a day, I had an attack of a-fib again! Dr. told me to go back up to 400 mg. again. Decided I couldn’t continue this medication any longer and went to another cardiologist. He was a young Dr. and suggested a cardiac ablation might work. Saw his electrophysiologist (who was terrific) and had the ablation. That cured the a-fib! Had this done in 2013. Anyone who is suffering from a-fib and can fit the criteria for an ablation should do it. There is a 70% cure rate for this procedure, which has it’s risks but sure beats taking amiodorone!

  4. Joleene
    Washington, Mo
    Reply

    After heart surgery I was put on Amiodorone. I had horrible side effects: loss of appetite, severe pain in lower groin with every step, lots of nausea just smelling food. I could only keep broth down. I loss lots of weight loss. Finally I found info about it from a website in UK.
    I told my cardiologist I needed to come off of it. He reluctantly agreed. Then told me I would probably have sideeffects for three months. I was furious!

    I went home and took a minimal dose of an herbal Tincture I made for fibromyalgia sufferers. Instead of the typical dose of 30 drops I used only 5 drops. After four small doses all my sideeffects were gone. I didn’t ask my doctor and didn’t tell him!! I was thrilled after four months of suffering I was feeling human again.
    As an herbalist I learned a powerful lesson about the efficacy of herbs over toxic and harmful drugs.
    I wish others that have suffered as I did with the amiodorone would realize the benefits of herbs.

  5. Eve
    Cambridge U.K.
    Reply

    I live in the UK and have had adverse effects and some of the symptoms you mention for Amiodarone, from the smallest dose of the Beta Blocker, Bisoprolol Fumarate, prescribed for Atrial Fibrillation. Are there any similarities between Amiodarone and Bisoprolol Fumarate?

    • Terry Graedon
      Reply

      Amiodarone and bisoprolol are in different drug categories and are mostly used for different purposes. There might be some overlap in side effects, though.

    • Mary
      NC
      Reply

      What herbal mixture did you take?

  6. Christine
    Australia
    Reply

    I was on AMIODARONE for 6 weeks. 1 week 600 mg daily, 1 week 400 mg daily, then 200 mg daily for 4 weeks. After 2-3 weeks my vision started to get blurry. I mentioned this to my doctor who told me to get my eyes tested. I also mentioned it to my cardiologist 1 week after my Cardioversiaon for atrial fibrillation who said he would get me to see an eye specialist.  But then he went on holiday and doesn’t come back until mid May. 

    2 weeks ago, I booked in to see the optician who wouldn’t prescribe new glasses for me as my eyesight had deteriorated more than double. She arranged for me to see an eye specialist. I saw the specialist who says I have dense cataracts in both eyes. But I have to wait 6 months to go in hospital to get them removed. I have never had any signs of cataracts at previous eye examinations.

    She said AMIODARONE wouldn’t have caused the cataracts but I am 100% positive it did. My eyes have never been brilliant but I could see things. Now everything is a blurr and getting worse. I have osteoarthritis, arthritis, crumbling discs which I do believe feel worse than before AMIODARONE. More often than not I just have this feeling of being ” off”. Can’t quite describe what it is, just feel somethings not as it should be. I very often feel quite nauseous for no reason. 

    I have a cough first thing in the morning which takes quite a bit of coughing to actually bring anything up. Then when I do, it’s just a small amount of very thick phlegm. If I had read all of what I know now, there is no way I would have taken AMIODARONE. 

  7. Justin
    Omaha Ne.
    Reply

    I was prescribed amiodarone tablets 200 mg twice daily for arrhythmia for approx. 5 years. Following a routine x ray for lung discomfort the summary come back as Hot. I was sent to an oncologist the next daythe next two years were rather chaotic. Cat scan showed multiple tumor like masses, up to 7cms. in sizehere is a breif squence of events. Pet scan, Persian 2 with contrast, three lung biopsies,blood work,lab work, respiratory testing and 17 different doctors.

    The tests came back negative for cancer. All the meantime I was still taking amiodarone for those two years that it took to complete the testing. I was thankful but I still was having mazor chest paid and other symtoms. I told my nurse navigator I was going to try another university. She said it would be a waste of time since the final diagnosis was a simple flu and to stay on the antibiotics for one more month. We’ll I didn’t listen and went to another university across town.

    The cardiologist I saw immediately pulled me off of the aniodarone. After three months the cat scan showed the masses on my lungs had shrunk. Also my blood had turned red again from being pitch black and my urine that looked like love canal waste was clear as water. There is lung scarring which is still annoying but bearable.oh,it wasn’t an arrythmia after all but an anxiety disorder which fooled the original key test I control it now with simple breathing andyoga I really felt like the stupidest fool on the planet for not knowing what I was putting in my body. I wish I had seen this post 5 years ago. Thanks good job!

  8. Noreen
    Colorado
    Reply

    It is so scary that s person can be given as IV medication in the hospital a terrible a drug like Amiodorone. I never give a blanket consent and want to know everything they want to do. I will not do IV insertion for bloodwork in an ER. I will not give permission for any IV unless I am informed. Medical care is in a sorry state. Avoid taking pharmaceuticals, and find natural remedies.

  9. MHT
    Chicago, IL
    Reply

    I had an aortic valve replacement at the end of April, 2017. My cardiologist prescribed five medications that she said were essential for me to take, two of which were amiodarone and lisinopril. When I filled the prescriptions, the pharmacist wanted to speak to me about his concern for me to be taking these two medications at the same time. When I said that was what my cardiologist prescribed, he said okay. Before the surgery I only took vitamins and other supplements, no prescribed medicine.

    I was finally taken off both amiodarone and lisinopril in September. I’d asked frequently to be taken off of all the meds. In October I went to an ophthalmologist for a routine eye exam, and after looking at my eyes he asked me if I was taking amiodarone. I told him not at the present time, but that I had taken it from April to September. He could see the residual effect of that medication in my eyes—not a good thing.

    I’m 79 years old and am still on atorvastatin and clopidogrel. I keep hoping my cardiologist will tell me I don’t need to be on either of these soon.

  10. Cardio
    florida
    Reply

    As a practicing Cardiologist and Internist, found Amiodarone the best drug to treat arrhythmias ever. Unfortunately it can be misused in higher strength, longer duration, and not the right indications. The western market in the last hundred years has not made such an effective drug as this. Yes, people do not like it because it saved hundreds of thousands dollars on procedures less effective but less criticised than the Amiodarone. After 37 years of using the medication, I still prescribe it. It is still life saving, despite all side effects. But there are only a few cases of side effects when you have a doctor who knows the drug and how to use it.

  11. Dan
    SD
    Reply

    I was put on amiodarone after developing afib last June. I could only take 6 doses of this poison before shortness of breath and congestive heart failure set in. Even though I stopped immediately, I suffered these symptoms for a month before they abated. The most dangerous aspect of amiodarone is its incredibly long half-life (57 days or more), which means even after you stop taking it, you’ll suffer for many weeks from the effects. This drug is a killer that is being misused by ignorant physicians and should only be used with caution as a last resort, not a routine treatment.

  12. Deb
    Ne.
    Reply

    I was on amiodarone for a short while but had dr. take me off because I was frightened to take it. I’m taking Multaq now, and it isn’t taking care of my afib. I was told I could go on amiodarone for 1 yr, have an ablation, or do a 3-day hospital stay to try another drug. Is there anything they can do for my afib?

  13. Kevin
    Missouri
    Reply

    My father in law has heart failure, a pacemaker, and an implanted defibrillator. Initially he was prescribed Tikosyn, but it was horribly expensive. Our only alternative was Amiodarone. Both my in-laws are in their 80’s, and money is a HUGE factor. They barely get by as it is. I wish they could afford something else, but the cardiologist said there is no other choice. That breaks my heart. Each day with my father-in-law is truly a blessing. I hope he stays around a little longer. Thanks for listening.

  14. Gwen
    Georgia
    Reply

    I am currently on oxygen 24/7 because of lung damage from being on Amiodarone. I NOW am also diagnosed with Pulmonary Fibrosis since treatment for heart issues. I had to be treated for HypoThyroidism for over 2 years due to the Amiodarone as well! Please, please, please be aware of the dangerous side effects of this drug! My Cardiologist NEVER once said one word or warning about this drug.

  15. Helen M.
    Modesto
    Reply

    I want to thank you two for covering difficult topics and telling us the real problems with several of the new miracle medications made in the last twenty to thirty years. This information has probably been a life saver for many people. You can begin each day knowing your work has had a positive impact over the years. Doctors have unrealistic expectations about how rich they can get in their profession. Perhaps that was true for specialists years ago; but it is not true today. When greed takes over and a physician squeezes in thirty or more patients in an eight hour day (must have family time, you know) there is no time for consideration before reaching for that prescription pad. And that pad in itself is a good way to cut short a visit. Hearing, let me know how it goes, does not worn you of danger ahead.

  16. Larry M
    Raleigh, NC
    Reply

    Joe wrote “Other medicines can affect the electrocardiogram to produce what is known as a long QT interval.”

    Did you mean to write “Other medicines can affect the _heart rhythm_ to produce what is known as a long QT interval.”?

    Amiodarone is nasty stuff. Fortunately I rejected it and insisted on a referral for a CPVA which completely resolved the a-fib with no follow-up drugs. Does anyone know why the cardiologists are so reluctant to refer patients to electrophysiologists and cardiac surgeons?

  17. BHM
    Reply

    I was diagnosed with AFib in 2001 and prescribed Tikosyn with 3 days stay in the Hospital. Continued for 6 weeks on Tikosyn without appreciable result. So my cardiologist ordered Amiodorone which I took until 2011 when I developed marked shortness of breath and signs of congestive heart failure. My interventional cardiologist performed a cardiac cath but found no coronary issues explaining my symptoms. Therefore she advised me to stop Amiodorone, and my symptoms disappeared .
    Yet when I saw an electrophysiologist a year ago, he advised me to start on Amiodorone but I refused. Eventually I went to Mayo Clinic in September 2017 where they put me on Tikosyn, and my A Fib symptoms have stopped. I am surprised and disappointed that my Cardiologist in 2001 discontinued my Tikosyn after a short trial and put me on Amiodorone

  18. Dolores
    Connecticut
    Reply

    My husband is a pancreatic cancer survivor. He was on Amiodarone for heart issues due to chemo. He developed a thyroid condition from it and finally got off it when he had the heart ablation. Still on thyroid pills but glad to be off amiodarone.

  19. Verna
    Reply

    I was given amiodarone after flu that left me with heart failure. It was given in the hospital by an IV which gave me horrible nausea among other things. I asked to be taken off that drug but was told if it was stopped there was nothing else they could do for me. After landing in the ER with afib months later, the ER dr. said no one over 65 should be on that drug and after conferring with my drs. he took me off. I struggled with nausea for some time after since the drug was still in my system but thankfully was able to shake it off. This is a drug of last resort and very dangerous.

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