Amiodarone 200MG

Today I posted the following information on my Facebook page to try to find out if anyone could give me any insight as to what to expect from using Amiodarone:

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HEY!! Is there a doctor in the house!?!?
On Thursday, I was prescribed a medication to help control my a-fib, a condition I have been dealing with for almost 20 years. On 22 March 2016, a pacemaker was implanted in me because my heart rate was slowing to sometimes less than 30 bpm. The pacemaker is now there to keep my heart rate from falling below 50 bpm, however, I still have the a-fib and my cardiologist has prescribed amiodarone to treat this. Now he even stated that there will be side effects while using this medication. I looked them up on-line:
You should check with your doctor immediately if any of these side effects occur when taking amiodarone:
More common
  • Cough
  • dizziness, light-headedness, or fainting
  • fever (slight)
  • numbness or tingling in the fingers or toes
  • painful breathing
  • sensitivity of the skin to sunlight
  • shortness of breath
  • trembling or shaking of the hands
  • trouble with walking
  • unusual and uncontrolled movements of the body
  • weakness of the arms or legs
Less common
  • Blue-gray coloring of the skin on the face, neck, and arms
  • blurred vision or blue-green halos seen around objects
  • coldness
  • dry eyes
  • dry, puffy skin
  • fast or irregular heartbeat
  • nervousness
  • pain and swelling in the scrotum
  • sensitivity of the eyes to light
  • sensitivity to heat
  • slow heartbeat
  • sweating
  • swelling of the feet or lower legs
  • trouble with sleeping
  • unusual tiredness
  • weight gain or loss
Rare
  • Skin rash
  • yellow eyes or skin
Incidence not known
  • Abdominal or stomach pain
  • agitation
  • back, leg, or stomach pains
  • bleeding gums
  • blistering, peeling, or loosening of the skin
  • bloating
  • blood in the urine
  • bloody, black, or tarry stools
  • blue lips, fingernails, or skin
  • blurred or double vision
  • chest pain
  • chills
  • clay-colored stools
  • coma
  • confusion
  • confusion as to time, place, or person
  • coughing or spitting up blood
  • cracks in the skin
  • dark urine
  • decreased urine output
  • depression
  • diarrhea
  • difficult or labored breathing
  • difficult urination
  • dry cough
  • eye pain
  • fast heartbeat
  • fatigue
  • general body swelling
  • high fever
  • holding false beliefs that cannot be change by fact
  • hostility
  • inability to have or keep an erection
  • indigestion
  • irregular, fast or slow, or shallow breathing
  • irritability
  • itching
  • joint or muscle pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • lethargy
  • loss in sexual ability, desire, drive, or performance
  • loss of heat from the body
  • lower back or side pain
  • mood or mental change
  • muscle cramps or spasms
  • muscle pain or stiffness
  • muscle twitching
  • no breathing
  • noisy breathing
  • nosebleeds
  • pain in the abdomen, groin, or scrotum
  • pain or burning with urination
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • pale skin
  • pinpoint red spots on the skin
  • rapid weight gain
  • rash
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • red, swollen skin
  • scaly skin
  • seeing, hearing, or feeling things that are not there
  • seizures
  • severe headache
  • sneezing
  • sore throat
  • sores, ulcers, or white spots on the lips or in mouth
  • stupor
  • swelling of the face, ankles, or hands
  • swelling of the scrotum
  • swollen or painful glands
  • tightness in the chest
  • troubled breathing
  • unpleasant breath odor
  • unusual bleeding or bruising
  • unusual excitement, nervousness, or restlessness
  • unusual tiredness or weakness
  • vomiting of blood
  • wheezing
Some of the side effects that can occur with amiodarone may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:
More common
  • Constipation
  • headache
  • loss of appetite
  • nausea and vomiting
Less common
  • Bitter or metallic taste
  • decrease in sexual interest
  • decreased sexual ability in males
  • dizziness
  • flushing of the face
Now, my question is, if I am already suffering from over a dozen of these symptoms which could be intensified by this medication, should I still take it?? My cardiologist says that he wants me to take this medication for a ‘couple weeks’ and then is planning to schedule a procedure at the hospital to ‘shock’ me back into rhythm. I have been ‘under the paddles’ once before about 17 years ago…received three jolts and it did not do anything to improve my rhythm. I am concerned that this will all be experimental in trying to get my heart better, but with the side effects from the medication and the possibility that nothing will come of my being shocked again, I am wondering if I should avoid this med and procedure.
I have sent a message to both my civilian primary care physician and my VA doctor for their opinion on this, but am wondering if anyone has had experience with this drug and what, if any problems they might have experienced with it.
Thanks in advance for any help. If you don’t want to respond here, please message me with your experience.

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Since I posted that note on my Facebook, I researched a little more and discovered the information below:

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What is amiodarone?

Amiodarone affects the rhythm of your heartbeats. It is used to help keep the heart beating normally in people with life-threatening heart rhythm disorders of the ventricles (the lower chambers of the heart that allow blood to flow out of the heart).

Amiodarone is used to treat ventricular tachycardia or ventricular fibrillation.

Amiodarone is for use only in treating life-threatening heart rhythm disorders. You will receive your first few doses in a hospital setting, where your heart rhythm can be monitored using an electrocardiograph or ECG (sometimes called an EKG).

Important information

Amiodarone is for use only in treating life-threatening heart rhythm disorders.

You should not take this medicine if you are allergic to amiodarone or iodine, or if you have a serious heart condition such as “AV block” (unless you have a pacemaker), a history of slow heart beats, or if your heart cannot pump blood properly.

This medicine can cause dangerous side effects on your liver or your lungs.

Call your doctor at once if you have: chest pain, trouble breathing, upper stomach pain, dark urine, jaundice (yellowing of the skin or eyes), or if you cough up blood.

Do not use amiodarone without telling your doctor if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.

To be sure this medication is not causing harmful effects, your blood may need to be tested on a regular basis. Your thyroid and liver function may also need to be tested, and you may need eye exams and chest x-rays. Do not miss any scheduled appointments.

Before taking this medicine

You should not use this medicine if you are allergic to amiodarone or iodine, or if you have:

certain serious heart conditions, especially “AV block” (unless you have a pacemaker);
a history of slow heart beats that have caused you to faint; or
if your heart cannot pump blood properly.
Amiodarone can cause dangerous side effects on your heart, liver, lungs, or thyroid.

To make sure amiodarone is safe for you, tell your doctor if you have:

asthma or another lung disorder;
liver disease;
a thyroid disorder;
vision problems;
high or low blood pressure;
an electrolyte imbalance (such as low levels of potassium or magnesium in your blood); or
if you have a pacemaker or defibrillator implanted in your chest.

Do not use amiodarone if you are pregnant. It could harm the unborn baby. Use effective birth control to prevent pregnancy during treatment.

Amiodarone can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

How should I take amiodarone?

Take amiodarone exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

If you have been taking another heart rhythm medicine, you may need to gradually stop taking it when you start using amiodarone. Follow your doctor’s dosing instructions very carefully.

You may take this medicine with or without food, but take it the same way each time.

It may take up to 2 weeks before your heart rhythm improves. Keep using the medicine as directed even if you feel well.

While using amiodarone, you will need frequent medical tests and chest x-rays to check your thyroid, vision, lungs, and liver function. Amiodarone can have long-lasting effects on your body. You may need medical tests for several months after you stop using this medicine.

If you need surgery (including laser eye surgery), tell the surgeon ahead of time that you are using amiodarone. You may need to stop using the medicine for a short time.

Amiodarone can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using this medicine.

Store at room temperature away from moisture, heat, and light.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of amiodarone can be fatal.

Overdose symptoms may include weakness, slow heart rate, feeling light-headed, or loss of consciousness.

What should I avoid while taking amiodarone?

Grapefruit and grapefruit juice may interact with amiodarone and lead to unwanted side effects. Avoid the use of grapefruit products while taking amiodarone.

Avoid exposure to sunlight or tanning beds. Amiodarone can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Amiodarone side effects

Get emergency medical help if you have signs of an allergic reaction to amiodarone: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Amiodarone takes a long time to completely clear from your body. You may continue to have side effects after you stop using it. It could take up to several months for the medicine to completely clear from your body.

Call your doctor at once if you have any of these side effects, even if they occur up to several months after you stop using amiodarone:

wheezing, cough, chest pain, coughing up blood, breathing problems that get worse;
a new or a worsening irregular heartbeat pattern (fast, slow, or pounding heartbeats);
a light-headed feeling, like you might pass out;
blurred vision, vision loss, headache or pain behind your eyes, sometimes with vomiting;
liver problems–nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
signs of overactive thyroid–weight loss, thinning hair, feeling too hot or too cold, increased sweating, irregular menstrual periods, swelling in your neck (goiter); or
signs of under active thyroid–extreme tired feeling, dry skin, joint pain or stiffness, muscle pain or weakness, hoarse voice, feeling more sensitive to cold temperatures, weight gain.

Common amiodarone side effects may include:

dizziness, vision problems, seeing halos around lights;
loss of coordination, feeling weak or tired;
nausea, vomiting, constipation;
numbness or tingling;
tremors; or
abnormal liver function tests.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Amiodarone dosing information

Usual Adult Dose for Arrhythmias:

Initial dose (IV): 1000 mg over the first 24 hours of therapy, delivered by the following infusion regimen:
150 mg over the first 10 minutes (15 mg/min),
followed by 360 mg over the next 6 hours (1 mg/min).
Maintenance infusion: 540 mg over the remaining 18 hours (0.5 mg/min).

Initial dose (PO): Loading doses of 800 to 1600 mg/day are required for 1 to 3 weeks (occasionally longer) until initial therapeutic response occurs.
When adequate arrhythmia control is achieved, or if side effects become prominent, the dose should be reduced to 600 to 800 mg/day for one month and then to the maintenance dose, usually 400 mg/day. Some patients may require up to 600 mg/day. Amiodarone may be administered as a single daily dose, or in patients with severe gastrointestinal intolerance, as a twice daily dose.

What other drugs will affect amiodarone?

Many drugs can interact with amiodarone. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:

an antibiotic–azithromycin, ciprofloxacin, clarithromycin, erythromycin, levofloxacin, moxifloxacin, pentamidine, rifampin, and others;
an antidepressant–amitriptyline, citalopram, desipramine, doxepin, imipramine, nortriptyline, trazodone, and others;
a blood thinner–warfarin, Coumadin, Jantoven;
cancer medicines;
a diuretic or “water pill”;
“statin” cholesterol medicine–atorvastatin, lovastatin, simvastatin, Lipitor, Zocor, Vytorin, and others;
heart or blood pressure medication–digoxin, disopyramide, dofetilide, flecainide, procainamide, propranolol, quinidine, sotalol, verapamil, and many others;
HIV or AIDS medication–indinavir, nelfinavir, rilpivirine, ritonavir, saquinavir; or
medicine to treat mental illness–chlorpromazine, fluphenazine, haloperidol, lithium, pimozide, promethazine, thioridazine, ziprasidone, and others.

This list is not complete and many other drugs can interact with amiodarone. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Amiodarone takes a long time to completely clear from your body, and drug interactions are possible for up to several months after you stop using amiodarone. Talk to your doctor before taking any medication during this time. Keep track of how long it has been since your last dose of amiodarone.
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So, I have been dealing with CHF for almost 20 years…taking my medication religiously to keep my heart working and with the addition of the pacemaker, I feel that I am on the right track to pursue diet and exercise to improve my health.  I have to say, I am a bit reluctant to take this new medication because of the potential side effects that come with it.

I will wait to find out what my VA health team says as well as my primary care physician on the outside who has been my doctor since 1991.

I am not ready to die….I sure as hell do not want to hurry the process along.

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Death and Heaven

OK…just floating through facebook, as I usually do…from friend to friend….seeing who to keep and who to drop….and I stumble on to this video. This video got my attention. I have never been a very religious man, but like I said, this video got my attention. It got me thinking. With the health scares I have had over the last year or so, I have been contemplating the afterlife…and if there even is one. If there is an afterlife …and it is filled with the people I love and miss, I think I want to be part of that. If there is an afterlife, I want to see my parents again. I want to see my lost brother, nephew, cousin, grandmothers ….everyone who has had an impact on my life.

For all of my life, I figured death was like …nothing. You cease to exist. Like going under anesthesia and not coming out of it. Nothing after….just ….nothing. To me, death was life’s final reward. No more stress…no more pain….just peace.

I do not fear death….I did when I was younger, but I have come to accept it and moved on with my life. It pains me when I hear of people committing suicide….especially veterans (who we lose to the tune of 22 per day). There is no respect in suicide. People can tsk, tsk, tsk all day long, but there is no excuse for killing yourself when there are so many ways of toughing it through your problems. So many people and programs to help you cope.

It pains me to learn of someone’s tragic death at a very young age. My nephew Joey Hoffman, my cousin Jayson Dimas Daday, my brother Joseph Hoffman. All died unexpectedly. Very painful news.

The young man who presented this very articulate and poetic speech is an inspiration to me. I am currently reading a book entitled ‘Muscle and a Shovel’ at a request of a former boss in the military and a dear friend of mine, CW4 (Ret) James Ross. The story is very interesting and I am beginning to develop a greater respect for religion and those who practise it.

Although I will never grasp the intensity of how religion is displayed by radical Muslims, I am sure there is a need for religion in all people’s hearts in one form or another. There is however, no room for anyone who practises a religion and causes pain or death because of their religious beliefs.

So, regardless of your actual religion…or in the cases where you do not follow any organized religion, but still have your own belief system (whatever that may be), we all share the same common ground. We die. Everyone dies. Some at a ripe old age of natural causes, some sadly, due to illness or disease and some even more sad, die dues to circumstances out of their control or suicide. We die. We know we are going to die. You learn to accept that and move on. Don’t waste your time worrying about when/how or if….accept the eventuality.

Get help if stress or anger, or any other uncontrollable issues have you considering suicide or just making life difficult to deal with. Please do not choose suicide as the answer to your problems.

Having said all of that. For people who are dealing with an illness or disease that will shorten their lives, causing unbearable pain and suffering, I truly believe that they should have the option to end their lives on their terms. Dr. Kevorkian was a man doing work well before it was an accepted practise. I believe assisted suicide should be an accepted medical procedure for those dealing with a very painful end of life disease. Politicians are all for allowing woman to make decisions when it comes to abortion, yet they still fight to keep assisted suicide from being an option to those who want it.

Watch the video below. Maybe you will get that little chill up your back, as I did when I watched it. Think about your life. Think about what you should do to make sure you are granted access to the afterlife that may be waiting for you.