Amiodarone side effects and toxicities 

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My dad is experiencing the same exact issue. Praying for both of our dads to get better and speedy recovery ❤️‍🩹

Oh dear- that sounds absolutely horrendous. My thoughts and prayers are with you and your family. I appreciate you sharing!

My fingers are crossed for your dad as well. Take care!

@@nicoleklian1179 hi nicole, just checking in to see how your dad is doing? Mine is faring ok, his lungs are still pretty bad and he has two chest tubes in but he’s been able to wean down to 4-10 liters of regular nasal cannula oxygen, the doctors were impressed he was able to recover that much after going on the vent. It’s gonna be a long road though, his lungs are definitely very scarred, not sure what the future holds. Hoping the same or better has happened for you dad too. Let me know ❤️❤️❤️

@@theheartpharmacistjust wanted to give this thread an update. My dad is not doing well and likely will be moved to comfort care tomorrow. This drug stripped him of his life, I cannot begin to process it, nothing about it feels real. He is the loveliest, kindest, funniest, smartest man alive and i shattered.

Thank you so much for stopping by! Although skin irritation is not a common side effect of warfarin, you may need to keep a close eye on it (and obviously that your doctor and pharmacist know) in case it is the early signs of a rare-ish side effects of warfarin like skin necrosis. If it's painful/sore, and/or starts forming a sharp border that begins to darken/turn purple, that is a red flag and you may need to seek medical attention sooner than later. Fingers crossed and take care!

@@theheartpharmacist Thanks so much for your reply! I have just subscribed!

Over the years, I have been less and less concerned of hypotension related to oral amiodarone as we often use it for patients who are hemodynamically unstable with atrial fibrillation or ventricular arrhythmias to actually keep them in sinus rhythm and improve their overall cardiac output, which actually improves their blood pressure. Even though amiodarone is thought of as a " dirty drug" , in that it also blocks sodium channels, as well as beta receptors and calcium channels, I find that in actual clinical practice I don't see very much effect on calcium channels that usually cause more profound hypotension. As you probably know, blocking beta 1 receptors with cardioselective beta blockers like metoprolol and bisoprolol, the effects of blood pressure lowering are very minuscule (they are lousy agents to use for hypertension). The only instance that I would sort of be concerned of amiodarone causing hypotension is if patients are decompensated heart failure/ cardiogenic shock and blocking beta 1 receptors possibly which would make it really hard for them to get out of cardiogenic shock, as they are fairly dependent on their beta1 activity for both inotropy (contraction) and chronotropy (heart rate) in that setting. Your question and feedback are much appreciated! Thanks for tuning in!!

I really appreciate this feedback. You are absolutely right - I know at times I can be quite cynical towards meds, especially when I'm seeing them so often, and all the bad things that they can do. I try not to lose sight of all the good things that they do as well and often when I'm critiquing medications and papers, I forget to highlight those positives. As now my audience has grown a bit more, I have to be ultra diligent in the way I convey my messaging. I'm constantly learning and growing as well and thank you for bringing this to light. Take care and all the best! Thank you for tuning in!

You're welcome! Glad it helps you remember!

I used amiodarone for a short period to calm my heart down. It worked well for my arithmia and no real side affects short term( 4 weeks)

Be careful. I have been on 200 mg since March. I also have seizures & severe depression, anxiety, MS and crohns. None of these meds work well with Amarodione. I am hoping to get off of it later this month. So far I have put on 10 lbs, and I still feel palpitations. I am officially considered in heart failure because the Afib appears to be uncontrolled. Even after an ablation. It's not good for low-functioning kidneys either. If I can't get off, my choices for treatment are greatly reduced. There are other meds out there that are not as dangerous to the body to monitor heart rhythm. I have just tried them all unfortunately unsuccessfully.

I am adding an update. I went to a new Dr. Was taken off Amarodione after being on it for over 6 months. I now have been upgraded to HF with preserved ejection fraction. However, my kidneys took a hit and have reduced from 65 to 40. So I will be working on preserving that. I also have hypothyroidism, which I have never had. We are hoping it returns to normal. Although, I have a Very Very strong FH of hypothyroidism with a grandfather who died on the OT in 1926. My father and 4 of his brothers, two sisters, and 3 nieces also have it. So it may complicate my recovery or add another medication to my list. This is a very known side affect of Amarodione. So we are giving it time to leave my system. That is another thing, it leaves your system very slowly rather like a long term dose of steroids. So it could be 3-4 months before I see what has happened . I do have some stiffening of the lower chamber that I didn't have in my last echo. So I am working on exercise, exercise and diet. Although because I am missing so much intestine makes that a little hard. Scar tissue rules my gut

Very interesting. It's possible that you may be experiencing palpitations while on amiodarone as it has the potential to alter electrical conduction but I assume that you were put on amiodarone for some type of arrhythmia in the first place. It could also be that the amiodarone is doing things like helping you convert from the rhythm that you don't want, back to sinus rhythm (The rhythm that you do want). It would be good if your heart doctor was able to capture the actual electrical activity of your " double beats" to see whether it was dangerous or not. If you stop amiodarone, effects may still linger for 6 months to a year for some people (has a really long half-life of about 50 days on average, we usually need about 4 to 5 half-lives for majority of the medication to leave the body). I hope this helps!

Oh my goodness, I can't believe I missed this comment. So sorry! It's heartbreaking for me to hear that he's had all these nasty things following just one dose of intravenous amio. Unfortunately, given that it's been several months now, I don't think there's a way to "suck out" the amio. His body has likely broken most of it down at this point but some toxicities can be permanent like lung scarring, even problems with thyroid function, despite the drug itself and its metabolites (breakdown products) have left the body. I wish him the best and that he gets better.. Take care and thank you for sharing your dad's story!

@theheartpharmacist Hi there, I was diagnosed with heart failure last year and following further tests which show my left ventricular systolic function is at 35% plus an irregular heartbeat, my consultant has asked my doctor to put me on Amiodorone but I'm very scared of the possible side effects. Do the pros really outweigh the cons when it comes to this medication?

Hi, I’ve struggled with AFib for sometime recently I tried flecanide to no avail, I then had a cardio version, for three weeks prior to that I was on a loading dose of 3x200 mg a day amiodarone when the cardioversion failed the specialist put me on a much higher dose 3x 400mg per day, my sinus rhythm returned after three days but I developed blurred vision, vertigo and nausea, as I am having an ablation in two more weeks I have been told to cease amiodarone for the two weeks prior to the procedure I am still in sinus after one week, which is a positive, my resting heart rate is 40 bpm but it’s always been slow at rest, I am still having fleeting vertigo type symptoms and my vision is still affected! I’m 76 should I have the ablation given my heart is back in sinus rhythm and whilst I am still having dizzy spells and how long will it take for the amiodarone to leave my system? Thanks for your informative presentation!!👍

hi @ickyjoe, I was on Amiodarone approx 2 years ago for 4 months (orally). The physician that prescribed it to me never followed up and wouldn't take calls for a follow up visit. During that time I became extremely fatigued, very weak, and found it almost impossible to breathe. Finally, one day my wife convinced me to go to the E.R. and I saw a Doctor on Locum from another area here in Canada. When She examined me and got my story she immediately called the prescribing physician and had a very heated conversation with him. she then told me to stop taking Amio immediately and check in with my family doctor. the next morning I got a call from the cardiologist's office scheduling a Cardio-vert 3 days later(Monday). Funny that he couldn't take my calls or see me for the previous 4 months. The Cardio-vert worked temporarily and I was eventually prescribed digoxin which helps a bit. While on Amiodarone I felt like I was going to die, I was very weak, I couldn't breathe, I had an extreme tightness in my chest and an overall sense that I didn't have much longer. I would be very careful with that drug. 2 years later I have lung problems, general weakness but extreme weakness and pain in my legs, and eye problems among others. I think that the symptoms that I am experiencing are permanent in that I've seen no improvement.

Excellent question. The problem with amiodarone is that it's quite different for everyone. However, on average for adults we're looking at around 50days for one half-life (meaning that it will take 50days for your body to clear out half of the drug). We usually will need about 4 to 5 half-lives for us to almost completely clear the drug from the body (which works out to over 6months to completely have amiodarone washed out for most healthy adults). The additional caveat too though, is that blood levels of both amiodarone (and its main active metabolite, N-desethylamiodarone) does not necessarily always correlate with effect on heart rhythm either - so no one would really be able to tell you at what point exactly that the antiarrhythmic effects from amiodarone are completely gone. I hope that's not too confusing for you! I trust that the plan to stop amiodarone was a joint decision between you and your heart doctor/electrophysiologist. Take care and appreciate you tuning in and leaving a comment!

@@theheartpharmacist thanks for your amazing detailed answer. Yes my EP put me on Amiodrone for 1 month post Ablation. Near the end of the first month they called and told me to continue for a second month based on my loop recorder implant. Naturally I'm concerned with the possible side effects. They assured me the short period of time I would be taking it limits the possibility of nasty side effects. Judging by what I read my dose seems comparatively low at 200 mg/day. Hopefully they don't call me and tell me to continue for a 3rd month. LOL Thanks for your amazing channel and helping people with heart issues.

@@theheartpharmacist this is the second time I'm referring to your answer. I thought I replied but I don't see it. Anyway thanks for the detailed response. Yes my EP guides my meds decisions. Thanks again.

@@lrc87290 RU-vid can be glitchy sometimes like that for me too! Your second response is much appreciated! Thanks again for tuning into and 🤞🏼 that you stay in sinus!!

@@theheartpharmacist thanks it's a rollercoaster ride for now. Luckily I'm mostly asymptomatic.

She is on it amiodarone twice daily as maintenance of normal rhythm? That sounds a little unnecessary. We usually load with twice daily first and maintain with once daily lower dose to prevent long-term toxicities. Sometimes the dose is split up because of inability to tolerate the medicine, but that's not common. The medicine stays in the body for a long time so doesn't really need twice daily dosing for long term. Maybe double check with your grandmas pharmacist/doctor?

@@theheartpharmacist I would not recomend this drug to anyone!

@@paulworgan6599 oh my god, Hope you’re ok???

Oh my goodness. I'm hoping that you sought medical attention soon after...

@@theheartpharmacist No I didn’t i seem okay

Me too, 200mg/day plus I had a central line loading dose into the vena cava. 24 hours of fun that was. To stop me worrying about Amiodarone the doc put me on Mexiletine too. The joys of drug-resistant VT eh? Hope you are doing well bud and please dont pull any more stunts like that, God bless

@@Ken_oh545 Thankyou