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dofetilide (Tikosyn)
Classification as antiarrhythmic group 1C by analogy.
Tradename: Tikosyn.
Prescribers must participate in the Tikosyn Education Distribution Program.
Pharmacy must be registered with Tikosyn in Pharmacy System (T.I.P.S.) program to stock or dispense Tikosyn.
Prescription must be stamped with the T.I.P.S. stamp, & initialed & dated by pharmacist. [3]
To verify that a prescriber has participated in the program see [4]
Indications:
1) atrial fibrillation
2) atrial flutter
3) chemical cardioversion
Dosage adjustment in renal failure:
- lower dose with eGFR 20-60 mL/min [5]
- avoid with eGFR < 20 mL/min [5]
Pharmacokinetics:
- metabolized in the liver by cyt P450 3A4
Adverse effects:
- ventricular arrhythmias (torsades de pointes)
Drug interactions:
1) any drug that inhibits cyt P450 3A4 may increase levels of dofetilide
2) any drug that induces cyt P450 3A4 may diminish levels of dofetilide
3) agents listed in ref [1]
a) cimetidine
b) erythromycin
c) ketoconazole
d) selective serotonin reuptake inhibitors (SSRI)
e) trimethoprim
f) verapamil
Interactions
drug interactions
drug adverse effects of antiarrhythmic agent, Group IC
Related
cytochrome P450 3A4 (cytochrome P450 C3, nifedipine oxidase, P450-PCN1, NF-25, CYP3A4)
General
antiarrhythmic agent, Group IC
Properties
MISC-INFO: elimination route LIVER
Database Correlations
PUBCHEM cid=71329
References
- Prescriber's Letter 7(10):59 2000
- Prescriber's Letter 13(3): 2006
Cytochrome P450 drug interactions
Detail-Document#: 220233
(subscription needed) http://www.prescribersletter.com
- T.I.P.S. enrollment form and information kit:
http://www.tikosyn.com/Order_Kit_TIPS.cfm#
(877) 845-6796
- T.I.P.S. enrollment verification
http://www.tikosynlist.com
(800) 788-7353
- A Pocket Guide to the 2019 Beer's Criteria.
American Geriatrics Society.