Amiodarone vs Dronedarone vs nothing

I just had an appointment with a VA electrophisiologist and I asked to be taken off of Amiodarone which I believe interferes with my thyroid hormones. I asked instead to be given a prescription for Dronedarone. He agreed that my gripe about Amiodarone was probably valid but counseled that Dronedarone was not very effective as an anti arrhythmic. He wrote me a prescription for Dronedarone but suggested I try quitting anti arrhythmics all together which I think I will do. I have two questions, first has anyone on the forum found Dronedarone effiective? and second if I did have another AFIB episode after giving up all drugs would trying to convert by taking a max dose of Amidodarone seem a reasonable thing to try? In other words I'd be just taking the Amiodarone briefly hoping it would help me get back into NSR.



Edited 1 time(s). Last edit at 06/18/2019 01:59PM by Josiah.

I've taken dronaderone twice, once when my afib was in full bloom and again later in the weeks following an ablation. It was completely ineffective at preventing my afib the first time, but the second time it did the job Natale intended. What Natale intended was a mild antiarrhythmic just to keep things quiet during the first month following the ablation, and it performed well in that role. I know it did because I tried to stop it before the month was up and all sorts of ectopics started creeping in so I resumed taking it and they stopped.

Based on my experience and the experiences of others I've heard from, if your afib is easily suppressed then it will probably work well for you. But if your afib needs bigger guns to suppress it, it probably won't work for you. In a nutshell, it's a weak antiarrhythmic, much weaker than flecainide, sotalol and propafenone, and way weaker than amiodarone.

Personally, I would get as far away from amiodarone as I could. I wouldn't even use it as a PIP. If the dronaderone doesn't work for you, ask the EP for flecainide and try that as a PIP. At least it won't destroy your lungs, your eyes, your thyroid, and turn your skin blue.

I’ve never heard of amiodarone as PIP, and it’s not a drug that you want to transiently mess with the dosing of. Remember that it doesn’t clear renally. It builds up in the body’s tissues over time (hence the blue skin phenomenon). It only exits when those cells physically die. So I don’t think stopping/starting in a scattershot manner is very effective at all and may even be dangerous.

PIP is accomplished with flec or Propafenone. You can add a beta, too, especially with the flec. I’d ask for that as a first step. You can always stop anti-arrhythmics entirely and just go with rate control plus anticoagulation and be completely safe from AF for many, many years. It’s a choice.

Has anyone gone off Multaq and been successful? I take multaq and Eliquis. I do not like how multaq makes me feel.

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Bmckeller48
Has anyone gone off Multaq and been successful? I take multaq and Eliquis. I do not like how multaq makes me feel.

Not sure what you mean by successful. If you stop taking it without replacing it with something else, then either your afib will return or it won't. If it does then you need something else.