Amiodarone is a very dangerous drug. My father, a retired OBGYN, woke up on January 1 2004, his 69th Birthday, with a temp of 100, general malaise, and sore throat.  Typical symptoms of the cold that was going around at the Holidays.  He stayed in bed and missed his Birthday Party. He felt a little better on the 2nd. On January 3, our nightmare began as a family, my Dad was short of breath and thought that he might have pneumonia. My mom, his wife of 47 years, took him to the urgent care clinic. He had a Chest X-ray and was immediately admitted to the Hospital, with an initial dx of bilateral pneumonia. On January 4, he was transferred to ICU. He did not respond to antibiotics within 24-48 hours, and his Cardiologist and Pulmonologist put their heads together and feared that he was suffering from Amiodarone Pulmonary Toxicity. He had a lung bx shortly thereafter that confirmed their dx.

My Dad had been on Amiodarone 200mg qd for 10 months, post oblation for chronic atrial fibrillation. He had no previously lung disease or open-heart surgery.

He c/o of a dry cough for 2-3 months. His primary care doctor thought it was ENT related, and referred him to the ENT. The ENT thought it was GI related and sent him to GI. He never made it to that appointment, as he was in ICU.

He was started on steroids within the first couple of days of his admission, and the amiodarone was dc'd.

 My Father had a normal CT scan of the lungs in the middle of Oct. 2003... Just 8 weeks later, fatal lung damage from Amiodarone.

His condition continued to get worse. He was put on a ventilator on January 18, 2004, which he was unable to tolerate. . He was on high pressures and developed subcutaneous emphysema, pneumoperitoneum and pneumopericardium. They changed him to a low tidal volume protocol that was developed by the ARDS Network His lungs were so severely damaged that he still was not getting enough O2 to sustain his life. He had to be put on Vecuronium in order to tolerate settings, which included 35 breaths/minute. 5 Children and a wife of 47 years, watched over him for 49 days, as his condition deteriorated, and Never improved.

The half-life of this drug is so dangerous. Once toxicity was dx, it didn't matter that the drug was dc'd as it continued to do damage. Steroids did not improve his condition at all.

 It appears that most literature I have read, states concerns with doses over 300mg/day.  Well, here is a case where a patient was only on 200mg/day for 10 months, and ended up with Fatal Pulmonary Toxicity.  In addition, they underplay the need for close monitoring of the lung status of patients on amiodarone. They absolutely need to come up with a new protocol, monitoring lung function much more frequently than q3-6months. A chest x-ray, had it been done even 8 weeks prior to this event, would not have clued anyone into the fact that he was developing Pulmonary Toxicity. He had a CT scan, which was Normal. 

I feel compelled to write to as many people as possible, to warn against the dangerous effects of this drug.

My father passed away, after 7 weeks in ICU, on February 20, 2004. He left behind, 5 broken hearted children, a broken hearted wife, 3 broken hearted grandchildren, 3 broken hearted sons-in law, and 1 broken hearted daughter in law.

Please, please, do what ever you can to put stronger warnings out, and push the drug companies to "red label" prescriptions, "If a cough or flu symptoms develop, contact your Physician Immediately. These can be signs of Pulmonary Toxicity, which can be Fatal, if left untreated"

In addition, I think patients should be required to sign a consent form, notifying them of the warnings.

Further, more needs to be done in the Medical Community to educate Primary Care Physicians of the severe effects of some drugs.

Red warning labels should be put on the Patients Medical Chart..

We experienced first hand, the very slight symptoms of Amiodarone Pulmonary Toxicity. My Dad's symptoms went unnoticed by him, a Physician, as they were so minor. He thought he had developed allergies, or that our air was too dry, and thus the dry cough.  He had no other symptoms that would have caused any alarm. Just 2 days prior to be hospitalized he enjoyed a wine tasting gondola cruise through the marina in Long Beach with his entire family. He was running around, getting in out of the boat just fine, no Shortness of Breath.  I lived with him, and he presented NO symptoms of concern. He was filled with energy and life, just 2 days before being hospitalized. 
Thank you for the opportunity to write my story.  I know that God knows the minute we are all going to die.  However, it doesn't mean that I can't try and make more people aware of the serious effects of this drug.

My Dad was a very strong man.  He had undergone many procedures and surgeries throughout his life, related to his DJD, and DDD, prostate, kidney, etc.. He recovered quickly.  That is why this drug is such a concern.

Karen M.