II. Indications
- Atrial Fibrillation Chemical Cardioversion (rarely used)
III. Contraindications
- QTc Prolongation >440 msec
- Creatinine Clearance <20 ml/min
-
Electrolyte abnormalities (Serum Potassium, Serum Magnesium)
- Correct levels prior to starting dose
- Concurrent use of medications that increase Dofetilide levels (see Drug Interactions below)
IV. Precautions
- Proarrhythmic
- Initiate in hospital with telemetry monitoring
V. Mechanism
- Sulfonamide
- Class III Antiarrhythmic
- Prolongs Cardiac Action Potential duration and refractory period (via delayed repolarization)
- Does not affect conduction velocity
-
Potassium Channel Blocker
- Selectively blocks cardiac ion channels (rapid component of the delayed rectifier Potassium current)
VI. Dosing
- Initiate in hospital with telemetry monitoring (typically 3 days)
- Minimum observation after cardioversion 12 hours
- Dosing is dependent on Creatinine Clearance and QTc Interval
VII. Safety
- Avoid in Lactation
- Pregnancy category C
VIII. Drug Interactions
- Other medications that prolong QTc Interval
- Medications that increase Dofetilide levels (contraindicated)
- Cimetidine
- Dolutegravir
- Hydrochlorothiazide
- Ketoconazole
- Megestrol
- Prochloroperazine
- Trimethoprim
- Verapamil
IX. Resources
Images: Related links to external sites (from Bing)
Related Studies
dofetilide (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
DOFETILIDE 125 MCG CAPSULE | Generic | $0.33 each |
DOFETILIDE 250 MCG CAPSULE | Generic | $0.57 each |
DOFETILIDE 500 MCG CAPSULE | Generic | $0.66 each |
tikosyn (on 1/1/2023 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
TIKOSYN 500 MCG CAPSULE | Generic | $0.66 each |
Ontology: dofetilide (C0114771)
Definition (NCI) | A sulfonamide class III antiarrhythmic agent and potassium channel blocker. Dofetilide selectively blocks cardiac ion channels of the rapid component of the delayed rectifier potassium current Ikr. This antiarrhythmic agent prolongs cardiac action potential duration and effective refractory period due to delayed repolarization without affecting conduction velocity. This results in a normal sinus rhythm. Dofetilide is used in the treatment of atrial fibrillation and flutter. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C063533 |
SnomedCT | 392658005, 116107002 |
English | 1-(4-methanesulfonamidophenoxy)-2-(N-(4-methanesulfonamidophenethyl)-N-methylamine)ethane, 1-MSPMPE, dofetilide, beta-((p-Methanesulfonamidophenethyl)methylamino)methanesulfono-p-phenetidide, dofetilide (medication), dofetilide [Chemical/Ingredient], DOFETILIDE, Methanesulfonamide, N-(4-(2-(methyl(2-(4-((methylsulfonyl)amino)phenoxy)ethyl)amino)ethyl)phenyl)-, Dofetilide (product), Dofetilide (substance), Dofetilide |
Spanish | dofetilida (producto), dofetilida (sustancia), dofetilida |
Ontology: Tikosyn (C0876188)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C063533 |
English | Tikosyn, tikosyn |