Multaq Anyone Else Take It
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Okay I will start off by saying this drug scares me because it has not been out for very long. I have Afrial Fib which is not behaving I can be 70 beats one min and regular and the next I will be at 190 and in atrial fib and flutter. this is my last chance at a med I have tried all the others I usually end up in the ER two or three times a week. I have had one ablation so far. If anyone else takes it please let me know what it is like. I am starting it on Tuesday.

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standard answer is that Multaq half-life is 24 hours, so most doctors would say it takes 5 days to clear. But it could take longer, as different people metabolize at different rates.

BTW, studies have shown that staying fully hydrated increases metabolic rate near 100 calories per day over what the average person drinks. Here in America where we are all well fed, the results of drinking more water can be significant over the long haul.

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Thanks everyone for your input on this. Steve, I am 55, and I know that drinking only a cup or two of water a day is totally crazy and not nearly enough, so I am trying hard to drink more. I have been like that my whole life so it is hard to make myself drink more, but I know it is in my best interests. I have noticed the coughing helps with my afib. Luckily I am having very few problems with it right now. I believe that mine was brought on by stress and trauma since it developed just a few months after losing both parents within a few months of each other. I have not taken my evening dose for three days, and today I decided not to take my morning dose either. So far so good. I will see how it goes. Does anyone know how long it takes for the Multaq to be completely out of your system?

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Check out the Pallas study on Multaq (dronedarone):

fda.gov/Drugs/DrugSafety/ucm264059.htm
and
nejm.org/doi/full/10.1056/NEJMoa1109867
and
internalmedicinenews.com/news/cardiology/single-article/pallas-trial-demotes-dronedarone-for-atrial-fibrillation/4b1b767cc8.html
and
forbes.com/sites/larryhusten/2011/11/14/pallas-poor-results-for-dronedarone-in-permanent-af/
etc.
All that said, the Pallas study was on more elderly Americans. That said, I have a friend on Multaq and it works well for her. She really likes it. But my EP is now reluctant to prescribe it because of the Pallas study. I had a serious thyroid blowup with amiodarone (a cousin of Multaq/dronedarone) about 11 years ago, so I am reluctant to try Multaq too. Tikosyn (dofetilide, which is considered to be more effective than dronedarone) did not work at all for me at either doseage, so he is probably right in my case.

For someone younger and with less ablation damage than me, it might be worth a shot, but be sure to have regular tests because a lot of different things went seriously wrong for a drug that was supposed to be safe, although in relatively few people. My guess is they are being quite cautious now because they do not know what the risk factors are for people taking Multaq. It might take years and a lot of studies before the risk factor is known.

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I was on Multaq for 2 years. It's a brutal drug and didn't seem to slow down my AF. I had ablation done in Sept. 2011 which put me into AF pretty well 24/7. The hospital wanted me to get cardioverted constantly, that was ridiculous after awhile and very exhausting. The cardioversions would only last me for 48 hours and then I'd be back into AF. I had my second ablation done in Jan. 2012, just over 3 months after my first one and I'm so happy to say I've been in sinus rhythm ever since. After my second ablation they took me off Multaq and onto Flecainide. I'm now off Flecainide, just still on a 5 mg. beta blocker and 110 mg. Pradaxa twice daily. I go back for my checkup early July and will hopefully be taken off the blood thinner. Hang in everyone, I think there is hope out there. Having had AF for 5 years really badly, it's such a relief to be in sinus rhythm all the time. I have not been allowed any caffeine, chocolate or alcohol since my ablations, feeling fairly pure these days, but looking forward to a glass of wine once I get off the blood thinner, if the doctor says okay. Good luck everyone, I would be very wary of Multaq, it's had some bad press up here in Canada.

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Peggy: You should drink plenty of water to stay fully hydrated at all times, especially if prone to A-Fib and other arrythmias, because dehydration increases risk of stroke. You didn;t say how old you are, but dehydration increases in older people because we gradually lose our sense of thirst as we age. So the risk of dehydration and stroke increase as we age.

To quickly stop palpitations, it can be helpful to quickly cough hard a few times (I call them tympany). It stimulates the vagus nerve and can often end tympany if you cough quickly. It has become second nature for me now. Once in a while one will continue and I am off onto a spell of arrythmia. My triggers seem to be caffeine, decongestants and MSG. I take extra extra magnesium with my calcium, potassium, either my prescription or low sodium V8 juice It. has 1180mg of potassium per 12oz (season with No-Salt or Low-Salt, pepper, hot sauce and maybe worcestershire sauce to taste.

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Thanks so much Joan. I desperately want to get off of Multaq. I have not taken it for the last two nights, only the am doses, and have noticed no increase in my afib. I have had some momentary fluttery feelings in my chest, but nothing more than I had already. So far so good. If I do start to have more, I will go back to a half of a pill in the evenings, but I hope I don't have to. I do want to start taking the magnesium, because I get very little from the foods I eat. I also think my afib does better when I drink more water, as I typically do not drink much of any kind of liquids, so I think I tend to get dehydrated and that makes the afib worse as well. We will see how this all goes.

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Peggy, when I first cut back to 1/2 dose it was as if I didn't take any at all. The afib came on so strongly my chest hurt. My fibs typically last 1-2 hours, never days, and occur when I least expect them. Lately, though, they occur much less frequently (maybe once a week, and are milder) so I can tolerate it. My goal is to get off Multaq and any other anti-arrhythmic drug completely. I'm also seeing a Naturopath and am getting chelation therapy to remove heavy metals because a test showed I was high in lead, cadmium and mercury, which could affect the heart-- not to mention the rest of the body. Last summer I started taking 500 mg. of Magnesium a day and that made a difference right away. Hope this helps.

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Hi Joan,

Thank you so much for your quick reply! I hate this medicine! I have felt generally worse since I started taking it (and everything else they tried me on first) than the afib makes me feel. The afib that I have had generally lasts for only a few moments at a time, not hours or days, but also can occur frequently. I "accidently" forgot to take my pm dose yesterday and lived through the night. lol What happened with you when you first went to the 1/2 pill twice daily, if you don't mind me asking? I am glad to hear you are doing so well with tapering off. That gives me much encouragement. Thank you!

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Hi Peggy, I have been tapering off Multaq for the past 3 months, after being on the same dosage and length of time you were. Now I'm down to 1/4 tablet 2x day, and if anything my episodes are less than they were when I was on the full dose. In my case, I believe Multaq made my afib worse. When I told the electrophysiologist I'd like to get off the drug, he suggested cutting back to 1/2. That didn't work well at all, so I went to 3/4 for about a month and then decreased it to 5/8, 1/2, 3/8, then 1/4, staying on each dosage for at least 2 weeks. The afib acted up each time I cut back but after about 3 days it subsided. It is a challenge to cut the pills, but I feel much better now. Good luck!

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Hi, I have been taking Multaq 2 x day for about 12 - 18 months. It didn't seem to help much until about the time I switched from metformin to Januvia, then my Afib seemed to all but disappear. I recently had to stop the Januvia and went back on the metformin, which seemed to cause a few momentary irregular heartbeats. I get short of breath very easily. Granted, I am obese, but I believe this is more from the Multaq and I would like to stop taking it. I guess my question is how should I decrease the dosage and what length of time should I expect to get off of it. If anyone else has experience with discontinuing Multaq, I would like to get your opinions. Thanks so much!

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Thanks Steve you are very knowledgable and it is much appreciated. I have cut out all caffiiene, salt, carbs and really wattch what I eat. I did drink two beers the other night at a benefit. Doctor said I could have a couple every now and then. As far as illegal drugs I totally agree that would be a no no for us heart patients.
Last night I ran into a hear a heart patient who shares my new cardio doc. He told me he worried for about the first two years and then got over it and learned how to deal with it. He is now 15 years into his condition nd having a blast in everything he does. He also assured me the heart doctor we have at Good Sam in Cincinnati is one of the best in a 600 mile radius, amazing how some information can go a long way and help your mind. It was so refreshing speaking to him I wish we had in person heart support groups in Cincinnati. I also appreciate this site, this is real people in real time. I had be scanning the internet like a wild person and there is so much negative out there alot of it dayed in 2009 and no new news on the complainers it makes me wonder why. God bless.

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Deb: there are lots of different conditions, no doubt, but PVCs are not what I had when in A-Fib. It is a separate arrythmia and usually not too serious unless it gets so frequent that you get faint. Usually I would only get PVCs when in normal sinus rhythm. It feels like a thud followed by a gap between beats (some people call it a missed beat), and then it starts in normal rhythm again. At least thats how mine was. Unless it is debilitating, it is usually not a serious situation. A-fib has its own signature in that it is irregularly changing irregular heart beats. A-Fib constantly changes. A-Fib runs at a slightly elevated rate, like maybe 30-40% faster than normal. but is even hard to take a pulse rate because some beats are strong and some are very weak. You need to be more frequently checking pulse because all these various arrhythmias have a different pulse rate signature. Some may be tachycardias, some A-Fib, some A-Flutter and some PVCs, and some are 'other' that might even fall into the 'sick sinus syndrome' category.
When in normal sinus rhythm I sometimes get what I call a 2-step (I it named after the Cajun and Zydego dance step) where it feels like 2 normal beats followed by a gap or skip, and it keeps on repeating. It will usually go on that way until I cough or if lying in bed, roll over on my left side. That usually ends the 2 step but earlier on in my condition would opften iniate my A-Fib - go figure! Unfortunately, we sense most all oif these arrythmias and have to learn to manage them where we can, and live with them where they are really uncomfortable. Meds have to be 'played with' to find the right levels and combos for you. And that can change over the years. There is no one size fits all. Right now I am trying two different Class Ic sodium channel blockers together (flecainide and propafenone) to try to maximize effectiveness while reducing side effects.
By the way, depression is one side effect of some of these meds, and panic attacks can be created by our minds when we have no knowledge, confidence or faith in what we are doing and are fearing for our futures. Everybody with these issues should understand that this condition requires a journey, and that there is often no quick and sure solution except for perhaps simple SVT which seems to be easily cured by right atrial ablation. We patients have to keep up to date enough to be able to know pretty much what our EPs know. And I would stay away from old-time cardiologists, because the only some of them know are cures are clogged arteries and installation of pacemakers (which I am trying to delay as long as possible, but the need for delaying pacemaker installation is another story).

It should go without saying, but I will say it anyway for those that may be uninformed - if you are looking here at this websire, you need to avoid caffeine most commonly found in coffee and soft drinks, avoid decongestants of any type, and avoid MSG. Avoid lidocane and some other drugs. And obviously we want to avoid stimulants such as various forms of meth, to avoid terminal cardiac arrest.

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Your story is inspiring thanks for sharing. Episodes of Afib are scary for me. It is really strange I went to the cardio for PVCs. Now with medication I seem to have more PVCs or I'm just more attentive to my condition.
Last night I went out with friends for dinner and had an anxiety attack and could not eat. Geting older is tough but with hope and faith I can get through these trying times.

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Deb: My A-Fib for over 20 years (now I have occasional left atrial tachycardia from ablation scar tissue breakdown in my left atrium) and various arrhythmias for 27 years, and for the vast majority of that time took nothing but a full size aspirin a day. Only when needed to prep for a procedure or cardioversion, have i used regular strength warfain (7mg/day for me) or 300mg/day Pradaxa. I have never had a stroke or TIA event and am now 67. I am active, exercise regularly, stay hydrated and watch my diet and supplements. Nowadays, in addition to the 325 mg aspirin, I also take low dose 2.5mg/day warfarin and a Ginko Biloba supplement tab for my DIY stroke prevention. I have no cardiovascular disease so this regimen can work for me. ...not recommending this for everyone but just putting this out here.

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Hi Deb from Cincinnati,

Thanks for your update - good luck to you!!

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Update
I have been on the meds now for 6 weeks, overcoming the side effects is becoming easier. I have noticed less weakness and I have lost 18 pounds which yes I needed to loose weight for sure. I have changed my diet and been exercising. I still have Afib and the doctor is upping my coreg next visit at the end of June. Good luck to all and try to have hope that was my biggest fear, what was going to happen to me. I'm able now to get my head around my condition and try to be as active as possible to deal with my condition

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Good wishes to you, Deb.

If you do wish to read some more on the internet that is probably about as accurate and balanced as possible, I recommend Dr John Mandrola's blog at
drjohnm.org

By the way, he is in Louisville.


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Second opinions count if you are not sure and have a gut feeling that something is not right go on your instict. I had my appoitment with my second opinion cardiologist at Good Sam in Cincinnati. This doctor told me the medicine I was on bystolic was dangerous because no studies had been done on folks like me with my condition, this drug had side effects of damaging the liver. He is switching me to Coreq today. I also discovered that with the right medication I can improve on my EF and possibly eliminate some of the medications. Another major discovery I found out yesterday after my new doctor is able to read the Echo I may only have to take baby aspirin instead of pradaxa.
All this is a far cry from being told from my first cardiologist that I would be on all four drugs from my original post for the rest of my life. My new cardiologist told me my worry is not accurate I need to relax and enjoy my life. I can sit in the hot tub no more than 10 mins, ride my horses, continue to work, and live. I know the good lord had a hand in all this leading to my friend Shelly who lead me to my new cardiologist and I'm so grateful. I will post my progress as it comes. Good luck to all out there you are in my prayers.

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You are correct I'm going to a different cardio today 4-23-2012 Amazing how a Dr. can send you home with four drugs that knock you on your butt and mess with your mind without giving a heads up
I'll post after I find the facts. Thanks so much

Deb


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Deb in Cinnci...I was shocked that the cardiologist told you to go home and look it all up on google. That is a cardiologist you DON'T want. What you should look up on google is his credentials, and the bio or rap on ANY cardiologist you see. DEFINITELY get a second opinion, and definitely research THAT physician, too. Google is only your backup to further inform yourself so that you can ask your cardiologist a lot of questions!

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