Re: Amiodarone

[Guest guest]

> Carolyn,

>

> Amiodarone is not used for a-fib (at least not usually)....it is used

> for serious ventricular arrhythmias.

>

> May I add my two cents to get another opinion.

>

> Lee

21% of the entries in my database might disagree Lee

http://www.dialsolutions.com/af/database/index.html?Adv=1 & _amiodarone=1#results

I know it wasn't designed for AF but it is fairly regularly used as a second or

third line med for AF

(maybe it should be 3rd or 4th line ???)

also see

ACC/AHA/ESC Guidelines for the Management of Patients with Atrial Fibrillation

http://www.acc.org/clinical/guidelines/atrial_fib/VIII_management.htm

I wondered if Carolyn had misheard cordarone (amiodarone) and coumadin

(warfarin) -

the latter is regularly used pre and post ablation.

--

D

[Guest guest]

*SNIPPET*

> I know it wasn't designed for AF but it is fairly regularly used as

a second or third line med for AF

> (maybe it should be 3rd or 4th line ???)

>

>> I wondered if Carolyn had misheard cordarone (amiodarone) and

coumadin (warfarin) -

> the latter is regularly used pre and post ablation.

> --

> D

***************************************************

........I hear you....and this is taken from the link you gave

me....

" There are scant prospective comparative data available on the use of

amiodarone to maintain sinus rhythm in patients with persistent AF,

but a favorable outcome has been reported when amiodarone was given

as a last-resort agent in uncontrolled studies. Amiodarone is

particularly useful in AF complicated by HF, but its use is limited

by potentially severe extracardiac side effects. The use of low-dose

amiodarone (200 mg daily or less) may be effective and may be

associated with fewer side effects (218,316,322). "

I think the reason we do not hear a lot about dofetilide (Tikosyn) is

because you have to be hospitalized for at least three days when

started on the stuff...and the hospital and staff has to be specially

educated by Pfizer in the use of the stuff, and there are just not

many doctors that are qualified at the moment, or hospitals either,

for that matter.

If you are interested, see the Protocol on the Pfizer site. But in

up date information the efficacy of dofetilide was 35% in a-fib, and

amiodarone was 4% (only slightly more than placebo.) This was

reported recently in the J CIRCULATION.

I do understand that Amio, tho is much better for controling

ventricular response.

I am surprised that so many are on amiodarone, particularly in view

of newer drugs.

You idea of Caroline " hearing " Cordarone instead of maybe Coumadin is

VERY possible.

What an adventure this stuff is.....one we could all do w/o!

Thanks for the heads up!

Lee

[Guest guest]

*BIG SNIPPET*

> I am one of the who " flunked " the test for Tikosyn, an announcement

> made by a group of EPs, standing at the open door to my double room

> in loud, senatorian tones, so that my " roommate " and probably folks

> in the rooms to the north and south, could know as well. Somehow

this drug verges into the Vioxx category. If I had know Pfizer was

exerting such " control " over its use, I would never have taken it. As

it was, I filled an official HIPAA complaint against the docs for

violation of patient privacy. Next time, they'll have the courtesy

to enter the room, and talk quietly and directly to the patient,

instead of treating him/her like a piece of lox.

************************************************

Dear Lew

It is unfortunate that some doctors have no respect for their

patients and I appreciate you filing a complaint.

Why did you flunk? (a strange way for a doctor to put it--)

In regard to Pfizer, because the drug can cause Torsades if the QT

interval grows too long--it must be started in an 'approved' hospital

where the personnel has been specifically trained and knowledgable--

in this situation the drug is relatively safe, does not fall into the

same category as Vioxx (where information was withheld)....

Dofetilide (Tikosyn) has helped many folks--and it does not have the

extra noncardiac side effects of Amiodarone.

I did not fare well on Tikosyn--my QT was fine and also creatine

levels, but unfortunately it was not strong enough to prevent

breakthru arrhythmias. I now take Amiodarone--am not happy about it

but it is working.

I believe Pfizer is 'doing the right thing'....plus the FDA is also

involved in this ruling of only doctors, nurses and hospitals

receiving special training may dispense. If you look at the Pfizer

site....any hospital can have their doctors, nurses trained if they

apply.

I'm sorry you had such a rough time of it.

Lee

[Guest guest]

It is one of the drugs of first choice in Portugal. They seem to have a more

down to earth policy regarding its use as it is a potentialy effective drug.

Driscoll wrote:

> Carolyn,

>

> Amiodarone is not used for a-fib (at least not usually)....it is used

> for serious ventricular arrhythmias.

>

> May I add my two cents to get another opinion.

>

> Lee

21% of the entries in my database might disagree Lee

http://www.dialsolutions.com/af/database/index.html?Adv=1 & _amiodarone=1#results

I know it wasn't designed for AF but it is fairly regularly used as a second or

third line med for AF

(maybe it should be 3rd or 4th line ???)

also see

ACC/AHA/ESC Guidelines for the Management of Patients with Atrial Fibrillation

http://www.acc.org/clinical/guidelines/atrial_fib/VIII_management.htm

I wondered if Carolyn had misheard cordarone (amiodarone) and coumadin

(warfarin) -

the latter is regularly used pre and post ablation.

--

D

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Nothing in this message should be considered as medical advice, or should be

acted upon without consultation with one's physician.

[Guest guest]

Amiodarone is notorious for its potential long term effects. I tried it

for about a month and forced to stop it owing to short term effect. I

would note first that it was very effective in maintenance of NSR.

During this whole month there was hardly a skipped beat. BUT.. I

experience a very serious amnesia. After few days I started suffering

from chest pains, and dizziness spells. Often, I would turn pale (so my

colleagues would tell me) and feel I was going to faint. In short, lousy

feeling beyond anything I have felt with any medicine before.

Still, wish to stress that amirodarone is being prescribed widely, and

many people, including members of this form, have attested that it has

proved effective and generally positive for them.

Joe Y.

Amiodarone

I read so much about how bad Amiodarone is yet I have seen no posting

from anyone about their actual experience and how it damaged them. I

have done a couple of net searches with the same result. Comments,

anyone?

Web Page - http://www.afibsupport.com

List owner: AFIBsupport-owner

For help on how to use the group, including how to drive it via email,

send a blank email to AFIBsupport-help

Nothing in this message should be considered as medical advice, or

should be acted upon without consultation with one's physician.

[Guest guest]

>

> I read so much about how bad Amiodarone is yet I have seen no posting

> from anyone about their actual experience and how it damaged them. I

> have done a couple of net searches with the same result. Comments,

> anyone?

>

Hi, you can browse the 109 entires in my database that have ticked

amiodarone.

http://www.dialsolutions.com/af/database/index.html?

Adv=1 & _amiodarone=1#results

(http://tinyurl.com/6b35w)

I'm in there, my entiry says...

amiodarone (gave me thyrotoxicosis but is the best thing I've taken for

the AF -didn't stop it happening though)

Fortunately for me my thyrotoxicosis is now fixed (it took around 18

months for my thyroid to recover)

If you search the archives on this board you'll find lots of posts with

people's experience of amiodarone.

The search feature at yahoo is a bit naff.

on the home page (http://health.groups.yahoo.com/group/AFIBsupport/)

at the bottom there's a 'message history section'

type 'amiodarone' and click on 'search archive'

Sadly, yahoo only search a small chunk of messages each time,

you'll get something like

'Searched Messages 34088-33948 of 34088 | Previous | Next'

at the top and bottom of the results page

you have to repeatedly click on next to slowly step through the archive.

N.B. even if you get no results on one of the pages you can still walk

backwards thruogh the archive by clicking on 'next'

If you've been collecting messages via email for a while it'll be

quicker just to search your emails.

Hope this helps.

--

D

[Guest guest]

Re the data back.....Did take a look at the entries here at the

sight...and except for a few serious exceptions--most of the side

effects were manageable.

I do not take it for a-fib, altho I do have fib occasionally. My

diagnosis was life-threatening VT (have ICD implanted, but that does

not stop VT, it will bring you back to life, tho')....Other anti-

arrhythmia drugs were tried and the rhythms broke thru.

I am now on amio--started in hospital 1200 for three days, 600 for a

week or so...and now am on 200 per day. I am doing very well, but

being watched closely as I also had asthma (seems to be in remission

for last few years)... The usual blood work done every 3 months and

pulmonary, liver, eyes, chest x-ray, etc.

I was just at the EP's office Friday and we are both pleased by the

way it is working. It has really given me a decent quality of life

back--but again, it is not being used in my case for a-fib.

Are my doctors happy to have me on amio---no they are not. As the

cardio put it--I'm too young (and I'm 65 and don't really consider

that young! LOL)

Yes, there are nightmares...which I'm handling...some dizziness...so

am extra careful about that...and so far insomnia has been a

problem...but I really don't consider these life-threatening and I'm

working thru them.

Amiodarone has eliminated paramedics rushing me to the ER all too

often...I was afraid to go anywhere...even when it was not VT and it

was a-fib, my rate was always over 140 or many times higher, and was

so uncomfortable I needed the rate control only a hospital setting

could offer.

I'm writing this to help those that may be considering amio. Wyeth

has indicated it is ONLY to be used for life-threatening arrhythmias--

and I would question any physician using it for a-fib, unless all the

other anti-arrhythmias do not work and the fib is at a high rate.

Time will tell what happens in my case...but already they are

suggesting I go down a bit in a few months (to 100 mgs)...and they

told me most of the serious side effects were/are seen at doses 400,

etc.

You do have to be careful in the sun--have to wear at least 15 suntan

lotion...and a hat...

Just another opinion....

Lee