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 |