Brief Answer:
Special attention is required to avoid drugs side effects.

Detailed Answer:
Hello! Thank you for asking on HCM! I understand your concern and would explain that in your conditions (non ischemic cardiomyopathy) the best strategy would be to optimize cardiac performance, without the unpleasant costs of deleterious drugs side effects.

As Amiodaron use did show serious side effects (and mostly because of inappropriate drug combinations), it would be wise to reconsult with your prescribing doctor, in order to minimize residual unpleasant effects imposed by such an interaction. It would be better to discuss the possibility of dose reduction, or discontinuation of existing drugs (preferably Coreg, at least for a while), and follow up after that, monitoring your heart rate, BP and coupled with your physical performance.

Please, try to keep in mind the following suggestions when discussing with your doctor:

The best indicator for guiding your therapy would be left ventricular ejection fraction (LVEF measured by ECHO) coupled with your clinical functional status (ability to perform different daily tasks). Based on your actual clinical scenario and prescribed treatment, could be concluded the diagnosis of heart failure (and low LVEF). In that case supraventricular arrhythmia and even ventricular ones may occur.
My suggestions would be as follows:
(1) Digoxin is a recommended drug to improve somehow cardiac contractility, and to control ventricular rate, especially in the presence of atrial fibrillation. Special attention should be paid when renal dysfunction is present (dose reduction is necessary), and hypokalemia (to avoid digoxin toxicity).
(2) Coreg shows a variable response in different HF patients; sometimes not well tolerated and exacerbating HF symptoms (like fatigue, dizziness, light headed,etc). So, an optimal dose titration is needed under close supervision of the prescribing doctor. When not tolerated at all, it is better to avoid it.
(3) Amiodaron is considered a first line anti-arrhythmic drug, but combination with digoxin and coreg is very dangerous (may exacerbate severe HF, and even extreme bradyarrhythmia). I would not highly recommend it in your case; better to follow a rate control line than rhythm control (and heralding so severe complications).
(4) One of the mainstay of HF therapy are diuretics; but this imposes a very careful follow up of electrolyte balance (you should check it frequently - every month, especially natrium and potassium).
(5) If ventricular arrhythmia is frequently present, then and ICD would be immediately required coupled with an optimization of circulatory hemodynamics by treatment modulation.
(6) Regarding pain relief, you may try paracetamol, of reduced doses of NSAIDs. Just talk to your doctor about that.
If you give me more medical data (lab and ECHO), I could advice more detailed opinions.

Hope to have been helpful to you. Greetings! Dr. Iliri

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