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Drugs reference index «dofetilide»

dofetilide


dofetilide

Generic Name: dofetilide (doe FET i lide)Brand Names: Tikosyn

What is dofetilide?

Dofetilide is a heart rhythm medication, also called an antiarrhythmic.

Dofetilide is used to help keep the heart beating normally in people with certain heart rhythm disorders of the atrium (the upper chambers of the heart that allow blood to flow into the heart). Dofetilide is used in people with atrial fibrillation or atrial flutter.

Dofetilide may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about dofetilide?

You should not use this medication if you have severe kidney disease or a history of "Long QT syndrome."

There are many other medicines that can cause serious medical problems if you take them together with dofetilide. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you. You may need to spend at least 3 days in a hospital setting when you first start taking dofetilide. This is so your heart rhythm and kidney function can be monitored in case the medication causes serious side effects.

Tell your doctor if you have an illness that involves diarrhea or vomiting lasting more than a few hours. Prolonged diarrhea or vomiting can lower your potassium levels, making it dangerous for you to use dofetilide.

To be sure this medication is helping your condition, your blood pressure will need to be checked on a regular basis. Your heart and kidney function will also need to be tested. Do not miss any scheduled visits to your doctor.

Dofetilide may be available only from a hospital or specialty pharmacy.

What should I discuss with my health care provider before taking dofetilide?

You should not use this medication if you are allergic to dofetilide, or if you have certain conditions. Be sure your doctor knows if you have:
  • severe kidney disease; or

  • a history of "Long QT syndrome."

There are certain drugs that should not be used together with dofetilide. Tell your doctor knows if you take any of the following medications:
  • verapamil (Covera, Calan, Isoptin, Verelan);

  • cimetidine (Tagamet);

  • ketoconazole (Nizoral);

  • prochlorperazine (Compazine);

  • megestrol (Megace); or

  • trimethoprim (Proloprim, Trimpex, Bactrim, Cotrim, Septra).

Before using dofetilide, tell your doctor if you are allergic to any drugs, or if you have liver or kidney disease.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take dofetilide. Your doctor will tell you if any of your medication doses need to be changed.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether dofetilide passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take dofetilide?

Take dofetilide exactly as it was prescribed for you. Do not take the medication in larger amounts or for longer than recommended by your doctor. Follow the directions on your prescription label.

Dofetilide comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Dofetilide may be available only from a hospital or specialty pharmacy.

You may need to spend at least 3 days in a hospital setting when you first start taking dofetilide. This is so your heart rhythm and kidney function can be monitored in case the medication causes serious side effects.

Your heart rate will be constantly monitored through electrocardiograph or ECG (sometimes called an EKG). This machine measures electrical activity of the heart. This will help your doctor determine the correct dofetilide dose for you.

Do not skip doses or stop taking dofetilide without first talking to your doctor. Stopping suddenly may make your condition worse. You may need to use less and less before you stop the medication completely.

Tell your doctor if you have an illness that involves diarrhea or vomiting lasting more than a few hours. Prolonged diarrhea or vomiting can lower your potassium levels, making it dangerous for you to use dofetilide.

To be sure this medication is helping your condition, your blood pressure will need to be checked on a regular basis. Your kidney function will also need to be tested. Do not miss any scheduled visits to your doctor.

Store dofetilide at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

See also: Dofetilide dosage in more detail

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include slow or fast heartbeats, shortness of breath, chest pain, feeling light-headed, or fainting.

What should I avoid while taking dofetilide?

Grapefruit and grapefruit juice may interact with dofetilide and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Dofetilide side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:
  • fast or pounding heartbeat, chest pain, shortness of breath; or

  • feeling like you might pass out.

Less serious side effects may include:

  • headache or back pain;

  • dizziness;

  • nausea, diarrhea, stomach pain;

  • sleep problems (insomnia);

  • stuffy or runny nose, cough, sore throat; or

  • mild skin rash.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Dofetilide Dosing Information

Usual Adult Dose for Arrhythmias:

125 mcg once a day to 500 mcg twice a dayDose is based on creatinine clearance and QTc interval prolongation. Dose is adjusted 2 to 3 hours after first dose based QTc interval.First dose:Creatinine clearance (Clcr) must be at least 20 mL/min.Clcr = 20 to < 40 mL/min =125 mcg twice a dayClcr = 40 to 60 mL/min =250 mcg twice a dayClcr > 60 mL/min = 500 mcg twice a daySecond dose - based on QTc interval increase:15 % or less increase = continue dosagegreater than 15% increase = decrease dose as follows:if first dose was 500 mcg BID, then use 250 mcg BID;if first dose was 250 mcg BID, then use 125 mcg BID;if first dose was 125 mcg BID, then use 125 mcg once a day.If at any time QTc becomes greater the 500 msec (550 msec in patient with ventricular conduction abnormalities), drug should be discontinued.

What other drugs will affect dofetilide?

Many drugs can interact with dofetilide. Below is just a partial list. Tell your doctor if you are using:

  • a diuretic (water pill);

  • HIV/AIDS medicine such as nelfinavir (Viracept) or ritonavir (Norvir);

  • drugs that can affect heart rhythm, such as bepridil (Vascor), cisapride (Propulsid), droperidol (Inapsine);

  • narcotic medication such as levomethadyl (Orlaam), or methadone (Dolophine, Methadose);

  • antibiotics such as clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), levofloxacin (Levaquin), moxifloxacin (Avelox), or pentamidine (NebuPent, Pentam);

  • an antidepressant such as amitriptyline (Elavil, Etrafon), desipramine (Norpramin), fluoxetine (Prozac), fluvoxamine (Luvox), imipramine (Janimine, Tofranil), or paroxetine (Paxil);

  • medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), haloperidol (Haldol), mesoridazine (Serentil), or thioridazine (Mellaril); or

  • heart rhythm medicine such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), ibutilide (Corvert), procainamide (Procan, Pronestyl), quinidine (Quinidex, Quin-Release Quin-G), or sotalol (Betapace).

This list is not complete and there may be other drugs that can interact with dofetilide. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist can provide more information about dofetilide.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 1.07. Revision Date: 4/12/2009 4:43:52 PM.
  • dofetilide Advanced Consumer (Micromedex) - Includes Dosage Information
  • Dofetilide MedFacts Consumer Leaflet (Wolters Kluwer)
  • Dofetilide Professional Patient Advice (Wolters Kluwer)
  • Tikosyn Prescribing Information (FDA)

See Also...

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