Hi, Star:  Amiodarone is a nasty drug.  According to Hale, it can take 
anywhere from 26-107 days for an adult to eliminate the drug, so who knows 
how long it could hang around in baby's system. And there is potential for 
the drug to accumulate in various body organs.  There are also some other 
kind of bizarre side effects - long term use causes the person's skin to 
turn blue and it is recommended that one avoid sun exposure, even for short 
periods of time.  According to Hale, the chief concerns are hypothyroidism 
in the baby as well as possible cardiovascular issues.  In the adult, these 
include further arrhythmias (amiodarone is an anti-arrhytmic) and 
congestive heart failure.
I myself was on this drug for about a year-didn't work, probably because my 
mind wouldn't let it, I was so concerned about these side effects.  
So...for the last 2 and a half years I've been on an even more dangerous 
drug dofetilide (Tikosyn) that does indeed work for me with virtually no 
side effects (Yeah!).  The danger lies in starting the drug.  I was put in 
the CCU for 4 days - the 1st dose is OK, but in the words of my 
cardiologist "the 2nd dose could kill you".  So, they prefer to very 
closely monitor a person when starting them on this particular medication.  
I did discuss Class III anti-arrhythmics with Tom Hale at the ILCA 
conference (not that I'm planning on nursing any more babies).  He had 
heard of dofetilide but wasn't very familiar with it - he recommended in 
these types of situations to work with a pharmicist who is willing and able 
to titrate the exact amount of drug that will appear in the mother's milk, 
so the most accurate decision can be made regarding breastfeeding.
Hope this helps.  Sorry for the length but I have become known as the 
Cardiac Queen in my circle of friends and colleagues because of my up close 
and personal experiences.

Pam Hirsch, RN,BSN,CLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL  USA
Advocate Good Shepherd Hospital

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