Dofetilide (Tikosyn) to Control Heart Rhythm
Unless otherwise noted, the following information about dofetilide (Tikosyn®) comes from the package insert.1
Dofetilide is an antiarrhythmic drug used to maintain normal sinus rhythm in those who have had afib or atrial flutter for longer than a week. Hospitalization for three days is required to start dofetilide. It should only be used for those who are highly symptomatic.
How to Use
This oral medication is taken twice daily. Your doctor will determine the correct dose for you.
Dofetilide can cause serious arrhythmias, including Torsade de Pointes, a very fast heartbeat that starts in the heart’s lower two chambers, called the ventricles.
Dofetilide should not be used for those with:
- Long QT syndrome, a heart rhythm condition that can cause very rapid heartbeats that might make you faint or even cause sudden death.
- Severe kidney disease.
Common Side Effects
These are common side effects of dofetilide.
- Chest pain
Serious Side Effects
Contact your doctor immediately if you:
- Feel your heart racing
- Feel dizzy
Talk with your doctor if you are taking these medications that should be avoided while taking dofetilide.
- Cimetidine (Tagamet), a stomach acid blocker
- Trimethoprim (Primsol), an antibiotic
- Verapamil (Ramipril), a heart medication
- Hydrochlorothiazide (Microzide), a blood pressure medication
- Ketoconazole (Nizoral, Xolegel, Extina), an antifungal medication
You will need regular heart rate and kidney function monitoring while on dofetilide.
The various guidelines have specific recommendations related to dofetilide.
- US guidelines (AHA/ACC/HRS) recommend dofetilide for patients with afib to convert to and maintain sinus rhythm, depending on underlying heart disease and comorbidities.2
- European guidelines (ESC) do not recommend dofetilide because of the risk of Torsades de Pointes.3
- Canadian guidelines (CCS) leave the choice of which antiarrhythmic to use for maintaining rhythm control up to the physician based on patient characteristics.4