Diltiazem and amiodarone
Common Questions and Answers about Diltiazem and amiodarone
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Its ironic - I saw another EP for a second opinion for my second ablation and we discussed antiarrythmic meds and the EP said Amiodarone is the most effective but that the side effects were bad and that he can easily prescribe it to someone in their 80s but not to me since I am (in his words) a baby. That EP is associated with a huge medical center and teaching college.
I have been receiving treatment for arrhythmia from the VA for about 10 years now (1999). I have had the shocks, the medication Amiodarone and now a pace maker. I take 240 MG's of Diltiazem twice a day, 100 MG of Metoprolol
twice a day and one table (.125) of Digoxin a day. My last visit to the Pace Maker clinic showed that in the past 90 days it had recorded 887 instances of my heart rate going over 160 bpm's.
The problem is that it can cause blood clots and that is why it needs to be treated. Amiodarone is a wonderful drug. I have seen it work countless times on the unit and had never once, seen any of the dreaded effects. Your healthcare is YOUR choice. Be as educated as you can be then make a decision, but if you do not feel confident in your cardiologist, you will never be able to trust them enough to let them make you better! Good luck.
I was to take one daily and my cardiologist would determine when I should come off Amiodarone. I took Amiodarone for 62 days. My cardiologist took several EKGs and Echo’s and determined there was no Afib so I came off Amiodarone. I was doing real well in recovery and finished my cardio rehab. A month later I started to get some shortness of breath and a racing heart beat. We both agreed that I should go back on Amiodarone.
I am 68 years and I recently had a 24 hour ecg monitor and stationary ecg taken due to fairly persistent arrythmias. These were of 2 types - missed beats (or irregular rythm) and paroxysmal tachycardia (beats to 160/min). The cardio specialist that analysed the ecgs said that everything was fine with my heart and that the arrythmias needn't be treated unless they become particularly bothersome. My BP is under control without medication - averages 137/85.
I had my first episode of afib last week, prior to that I have been having issues with them regulating my blood pressure medicine. Currently I am on amiodarone 200 mg once a day and norvasc 2.5 mg and 12.5 mg of hctz and one xarelto a day. The problem I am having is when I walk across the room from the chair to the bathroom my BP jumps up to 170/90 and makes the back of my head feel full and I get a little dizzy. Do I need to switch BP meds ?
I was put on amiodarone for Long QT and 32 R/T events shown by 24-hour Holter. Heart steadied in 6 months but after a year TSH showed 38 and amio was changed to propafenone. Four ECGs and thyroid test in last six months show normal. But symptoms continue: Pre-syncope, dizziness, nausea, fatigue, 6 to 10 days a month. My cardiologist is alarmed by the pre-syncope.he suggests : another Holter, return to amiodarone, see electrophysiologist, EEG for brain conduction.
When my husband got atrial fibrillation and his Cardiologist wanted to put him on Amiodarone, I was well-versed enough to question the decision and he went on Flecainide instead. From the research I did when my husband had AFib (since cured with ablation), I was given to understand that Amiodarone is often used as a last-ditch attempt when other avenues have already been pursued. Flecainide is a better option if you can take it.
It really depends on what you need. If this has been prescribed for you, and you are uncertain about it, then you can always ask your doctor for more clarification. It really just all depends on your individual circumstances.
I would worry about interactions between so many medications. How many different meds are you taking? It could be 10 meds at 3-4 times a day. I've had 3 ablations and still have brief tachy times, PVC's and PAC's and occasional bits of chest pain. But I only have one pill (Diltiazem) that I take if my tachy gets stuck and won't stop. I'm not required to take it every day. Are all your pills related to heart arrhythmia?
Greetings,
My background:
Routine thyroid blood test by cardiologist regarding Crestor, etc. in Aug '12 reveals TSH 0.02, T4 1.9. T3 OK at 4.6 (little high): so, hyperthyroid. Primary care physician orders ultrasound and comes back with slightly enlarged right lobe and two nonspecific nodules, larger being .9 cm. PCP sends me to Endocrinologist - first appointment is early September.
I have suffered with taking diltiazem(180 mg ER) AND metoprolol (50 mg ER) for atril fibrillation for the past two and a half years. The side effects have been debilitating.. Both drugs have the same side effects and together and one or the other or both create what I can only describe as chaotic turbulence in my chest and pain in my left arm when the second drug kicks in.. My cardiolgist now wants me to add a blood thinner (xarelto) to my meds menu.
Everytime I went to the hospital for my a-fib or a-flutter that would not stop, they cardioverted me with amiodarone. From what I understand and was told by 2 EP's that amiodarone works very well for a-fib , however they would not let me take it for long term due to my age. I was told the side effects from long term use was to risky. So I was put on rhythmol then atenolol and then finally sotalol with cardizem.
Not all of us respond the same to the same medications. The indapamide worked better for you than the dilitazem so it only makes sense to stay w/the indapamide and forego the diltiazem since your doctor obviously didn't consider the indapamide and diltiazem a good combinantion.
I understand about uninsured doctor visits. We lost our family doctor of some 30 years and got a rude shock when we started doctor shopping!!! From a standard $35 office call to a $150 initial office call!!!!!
Oh, I forgot to mention, my EP wants to switch me to Amiodarone and I am really resistant because of the side effects. I'm currently on Sotalol because my primary problem is Vtach and Amiodarone is indicated because it controls both Afib and Vfib. I too have had problems with chronic bronchitis and occassional wheezing but I'm more concerned about the great number of other side effects!
There is a current study on something called ATI-2042 but it is only in early trials.
Your blood pressure needs to be well controlled and you should be on a BETA-BLOCKER with high BP and an aortic aneurysm. Generally amiodarone is only given short term and I would discuss the med changes with the cardiologist.
The reason I have not responded since July 7 is because I almost died from Amiodarone Lung toxicity. I have been in and out of the hospital and was put on high doses of prednisone. I ballooned up 40 pounds. It has taken me over a year to recuperate and now I have some permanent scarring in my lungs. I finally went to another electrophysiologist and had a procedure called a Pulmonary Vein Ablation. Was it worth it? I think so but it has only been one month since the surgery.
You can treat his hpothyroidism with thyroid replacement and continue the amiodarone or stop the amiodarone. His atrial fibrillation will likely recur in this case, as his ejection fraction is low. He may be able to use other medications such as tikosyn, dronaderone or sotalol to keep him in rhythm. If he is not symptomatic with the atrial fibrillation he may simply need to be rate controlled and anticoagulated with coumadin.
What is the etiology of his cardiomyopathy?
New doctor has taken me off 100mg Amiodarone and replaced with 25mg toprol XL. I am experiencing dizziness, extreme sensitivity to heat and sunlight, confussion...I have waited a week thinking the side effects would subside. Internet research has led me to believe that the amiodarone can stay in my system for up to ninety days...or is it the beta blocker I am having a bad reactiont to??? Did the amiodarone damage my eyes? My vision has declined substantially over the past two years.
He said I might put an 88 year old on Amiodarone not a 48 year old. He took me off the Amiodarone and I am just on Toprol, Xarelto and HCTZ. Do I have to go back to the cardiologist that put me on the Amiodarone? Or would you just say no! Do I have to have a Cardiologist as well as a EP guy? Just wondering what is your opinion?
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