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Dofetilide (Tikosyn) Considerations for Use*. US/FDA Special Notes. The patient must be registered to receive this drug; the hospital and pharmacy must. Easy to read FDA package insert, drug facts, dosage and administration, and adverse effects for Tikosyn (Dofetilide). (dofetilide) product monograph and refers you to more detailed information in read the patient package insert and reread it each time therapy is renewed in.
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Consequently, CYP3A4 activity in the gut wall is inhibited until de novo synthesis returns the enzyme to its previous level. Major Drugs packagd are actively secreted via cationic tubular secretion, such as triamterene, should be co-administered with caution with dofetilide since they could increase dofetilide plasma concentrations via potential competition for renal cationic secretion.
Because of the potential for torsade pointes TdPuse of dofetilide with degarelix is contraindicated. Major Indapamide may induce hypokalemia, increasing the potential for proarrhythmic effects e. Severe Concurrent use of dronedarone and dofetilide is contraindicated.
This results in a possible increase in plasma concentrations of either drug. Patients with atrial fibrillation AF should be anticoagulated according to usual medical practice prior to electrical or pharmacological cardioversion.
Severe Limited data, including some case reports, suggest inser olanzapine may be associated with a significant prolongation of packagd QTc interval in rare instances. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. Major Corticosteroids can cause increases in blood pressure, sodium and water retention, and hypokalemia, predisposing patients to interactions with certain other medications.
Severe Lithium has been associated with QT prolongation. Dofetilide plasma concentrations are linearly related to drug dosage.
Severe Because of the potential for torsades de pointes TdPconcurrent use of granisetron and dofetilide is contraindicated. Prolongation of the QTc interval and ventricular arrhythmias have been reported in patients treated with ivosidenib.
Careful patient monitoring and dose adjustment of dofetilide is recommended. Dosage adjustments based on determinations of renal function are critically important. Severe Cimetidine is an inhibitor of renal cationic tubular secretion and is contraindicated with dofetilide due to the potential for increased plasma dofetilide concentrations and associated proarrhythmias.
Fingolimod initiation results in decreased heart rate, and Inert III antiarrhythmic drugs have been associated with cases of torsades de pointes in patients with bradycardia.
The increase in QTc is approximately 10 milliseconds at doses of mg twice daily the FDA-approved dose and up to 25 milliseconds at doses of mg twice daily.
Refer to the step-by-step procedure above for determining the initial dosage of dofetilide. Related Drug Information Drug Summary. Cobicistat; Elvitegravir; Emtricitabine; Tenofovir Alafenamide: Rucaparib is a weak CYP3A4 inhibitor and dofetilide is a minor CYP3A4 substrate; however, because there is a linear relationship between dofetilide plasma concentration and QTc, concomitant administration of CYP3A4 inhibitors may increase the risk of arrhythmia torsade de pointes.
Major Coadministration of CYP3A4 inhibitors, such as darunavir, with dofetilide may decrease the metabolism of dofetilide, thereby increasing the potential for QT prolongation.
Cases of QT prolongation and TdP have been reported during postmarketing use of fluvoxamine. Severe Because of the potential for torsade de pointes TdPuse of macimorelin with dofetilide is contraindicated. Generally, dofetilide does not affect blood pressure; however it may reduce heart rate by about beats per minute. Patients should be advised to only use hawthorn with these antiarrhythmic agents after discussion with their prescriber.
Hawthorn thus has effects similar to the class III antiarrhythmics and would theoretically interact with drugs with similar cardiac electrophysiology e. It is prudent to avoid the use of any thiazide diuretic in combination with dofetilide. Patients with sick sinus syndrome or with 2nd or 3rd degree AV block were not included in Phase III clinical trials unless a functioning pacemaker were present. Severe Due to the potential for torsade de pointes TdPconcurrent use of dofetilide with bedaquiline is contraindicated.
Doses 6 mg SC do not provide additional clinical benefit and are not recommended.
If packag together is necessary, obtain an ECG prior to lacosamide initiation and after treatment has been titrated to steady-state. Dofetilide is associated with a well-established risk of QT prolongation and torsades de pointes TdP.
Severe Ezogabine has been associated with QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Major Coadministration of CYP3A4 inhibitors, such as nelfinavir, with dofetilide may decrease the metabolism of dofetilide, thereby increasing the potential for QT prolongation. Additionally, posaconazole has been associated with prolongation of the QT interval as well as apckage cases of torsade de pointes; avoid use with other drugs that may prolong the QT interval and are metabolized through CYP3A4, such as dofetilide.
Bismuth Subsalicylate; Metronidazole; Tetracycline: Moderate Monitor for an increase in dofetilide-related adverse reactions, including QT prolongation, if coadministration with dalfopristin; quinupristin is necessary.