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All about: dofetilide

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Generic Name: dofetilide (dough FET ill ide)
Brand Names: Tikosyn

What is dofetilide?

Dofetilide is in a class of drugs called anti-arrhythmic agents. Anti-arrhythmic drugs affect the way the heart beats (rhythm).

Dofetilide is used to treat irregular heartbeat patterns.

Dofetilide is not appropriate for everyone with irregular heartbeats. If you have atrial fibrillation (a specific type of irregular heartbeat), you and your doctor should carefully discuss the benefits and risks of dofetilide and whether your symptoms are troublesome enough for you to start taking dofetilide. In some patients treated with dofetilide for atrial fibrillation, dofetilide may cause a different type of abnormal heartbeat that can be dangerous, and in rare instances can even cause death.

Dofetilide may also be used for purposes other than those listed in this medication guide.

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

Dofetilide is not appropriate for everyone with irregular heartbeats. If you have atrial fibrillation (a specific type of irregular heartbeat), you and your doctor should carefully discuss the benefits and risks of dofetilide and whether your symptoms are troublesome enough for you to start taking dofetilide. In some patients treated with dofetilide for atrial fibrillation, dofetilide may cause a different type of abnormal heartbeat that can be dangerous, and in rare instances can even cause death. It is for this reason that you will be in a facility that can do special tests and monitoring for a minimum of three days when you start, or re-start, dofetilide. Dofetilide is available only from hospitals and doctors who have received special training.

Do not skip doses, take more doses, change your dosing schedule, or stop taking dofetilide without first talking to your doctor. Changing the medication schedule could make your condition worse.

Call your doctor immediately if you faint, become dizzy, or have fast heartbeats. Take your dofetilide capsules with you and show then to the doctor or nurse. If you cannot reach your doctor, go to the nearest hospital emergency room. Also, call your doctor right away if you have severe diarrhea, unusual sweating, vomiting, less appetite than normal, or more thirst than normal. These conditions may increase the likelihood of dangerous irregular heartbeats.

Who should not take dofetilide?

Do not take dofetilide without first talking to your doctor if you
  • have heart problems in addition to irregular heartbeats;

  • have a low level of potassium or magnesium in the blood;

  • have kidney disease or are on kidney dialysis;
  • have liver disease;

  • are taking any of the following medicines: cimetidine (Tagamet, Tagamet HB), verapamil (Calan, Calan SR, Covera-HS, Isoptin, Isoptin SR, Verelan, Verelan PM), ketoconazole (Nizoral), trimethoprim alone (Proloprim, Trimpex) or the combination of trimethoprim and sulfamethoxazole (Bactrim, Septra, others), prochlorperazine (Compazine, others), or megestrol (Megace).

You may not be able to take dofetilide, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Dofetilide is in the FDA pregnancy category C. This means that it is not known whether it will harm an unborn baby. Do not take dofetilide without first talking to your doctor if you are pregnant. It is unknown whether dofetilide passes into breast milk. Do not take dofetilide without first talking to your doctor if you are breast-feeding a baby.

How should I take dofetilide?

Take dofetilide exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Treatment with dofetilide will be started in a hospital where your doctor will monitor your heart rhythm for the first three days of treatment. This will allow your doctor to find the right dose for you.

Take each dose with water.

Dofetilide can be taken with or without food. However, it is important to take dofetilide at the same time each day. It may be helpful to take dofetilide at the same time as something you regularly do every day.

Keep taking dofetilide until your doctor tells you to stop. Keep taking it even if you feel fine. However, never take an extra dose of dofetilide, even if you do not feel well.

Do not skip doses, take more doses, change your dosing schedule, or stop taking dofetilide without first talking to your doctor. Changing the medication schedule could make your condition worse. When it is time to stop taking dofetilide, your doctor will give you instructions on how to gradually reduce your dose over a period of 1 to 2 weeks.

Dofetilide is not available at your regular pharmacy. Dofetilide is available only through one pharmacy. This pharmacy will mail your dofetilide directly to the address that you have provided. The pharmacy will use overnight service to mail the dofetilide to you without charge. Contact this pharmacy 10 days before your refill is due to order more medication each month. Remember to contact the pharmacy if you are moving or going on vacation.

In the Patient Resource Kit that comes with your medication, you should receive several "TIKOSYN Patient Information Cards." Give one card to your pharmacist. This card will inform your pharmacist of the other medications that you should not take while you are on dofetilide.

If you are admitted into a hospital for any reason, bring your bottle of dofetilide with you. This hospital may not have dofetilide. Make sure that the doctor or nurse knows that you are on dofetilide. Also keep a list of all medications, vitamins, herbal supplements, and other products that you take and bring this to the hospital with you also.

Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

Try not to miss any doses of this medication. Missing doses could be dangerous.

If you do miss a dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication. A double dose could be dangerous.

What happens if I overdose?

Seek emergency medical attention if you took more dofetilide than you should have. Call your doctor right away or if you can not reach your doctor, go to the nearest hospital emergency room. Take your dofetilide capsules with you to show to the doctor or nurse.

Symptoms of a dofetilide overdose include a slow heartbeat, fainting, dizziness, weakness, and confusion.

What should I avoid while taking dofetilide?

Do not take any other prescription medicines or over-the-counter products (including vitamins, natural supplements, and natural or herbal remedies) during treatment with dofetilide, without first talking to your doctor or pharmacist.

Tell your doctor or dentist that you are taking dofetilide before you have an operation or dental surgery.

If you are admitted into a hospital for any reason, bring your bottle of dofetilide with you. This hospital may not have dofetilide. Make sure that the doctor or nurse knows that you are on dofetilide. Also keep a list of all medications, vitamins, herbal supplements, and other products that you take and bring this to the hospital with you also.

Dofetilide side effects

If you experience any of the following serious side effects, stop taking dofetilide and call your doctor immediately or seek emergency medical treatment:
  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; hives);

  • dizziness or fainting;

  • fast heartbeats;

  • severe diarrhea;

  • unusual sweating;

  • vomiting;

  • less appetite than normal; or

  • more thirst than normal.

If you experience any of the following less serious side effects, continue taking dofetilide and talk to your doctor:

  • headache or dizziness;

  • chest pain;

  • respiratory tract infection or difficulty breathing (dyspnea);

  • nausea or flu-like symptoms; or

  • insomnia (difficulty in falling asleep or staying asleep).

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect dofetilide?

Do not take dofetilide without first talking to your doctor if you are taking any of the following drugs:
  • cimetidine (Tagamet, Tagamet HB);

  • verapamil (Calan, Calan SR, Covera-HS, Isoptin, Isoptin SR, Verelan, Verelan PM);

  • ketoconazole (Nizoral);

  • hydrochlorothiazide (HCTZ) alone (Microzide, Oretic, others) or in combination with other drugs (e.g. HCTZ/amiloride (Moduretic), HCTZ/benazepril(Lotensin HCT), HCTZ/quinapril (Accuretic), and others)

  • trimethoprim alone (Proloprim, Trimpex) or the combination of trimethoprim and sulfamethoxazole (Bactrim, Septra, others);

  • prochlorperazine (Compazine, others);

  • megestrol (Megace);

Dofetilide should not be taken with any of the medications listed above.

Many other medications may also interact with dofetilide, potentially resulting in decreased effectiveness of the medication or dangerous side effects. Do not take any other prescription medicines or over-the-counter products (including vitamins, natural supplements, and natural or herbal remedies) during treatment with dofetilide, without first talking to your doctor or pharmacist.

Where can I get more information?

  • Your pharmacist has additional information about dofetilide written for health professionals that you may read.

What does my medication look like?

Dofetilide is available with a prescription under the brand name Tikosyn. Dofetilide is not available at your local pharmacy. It is only available only through one pharmacy. This pharmacy will mail dofetilide directly to the address that you have provided. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

  • Tikosyn 125 mg-- light orange cap and white body capsules

  • Tikosyn 250 mg--peach-colored capsules

  • Tikosyn 500 mg-peach and white capsules

  • 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: 1.04. Revision Date: 12/17/04 10:33:36 AM.

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