Adult Dosing
Atrial fibrillation / atrial flutter [AF/AFl]
- Dose based on CrCl and QTc
- CrCl >60 mL/min, QTc <440 msec
- Starting dose: 500 mcg PO bid
- Titration:
- If QTc >15% over baseline or >500 msec after 2-3 hours of first dose; reduce dose to 250 mcg PO bid
- If QTc >500 msec after the second does; discontinue the treatment
- CrCl 40-60 mL/min, QTc <440 msec
- Starting dose: 250 mcg PO bid
- Titration
- If QTc >15% over baseline or >500 msec after 2-3 hours of first dose; reduce dose to 125 mcg PO bid
- If QTc >500 msec after the second does: discontinue the treatment
- CrCl 20-40 mL/min, QTc <440 msec
- Starting dose: 125 mcg PO bid
- Titration
- If QTc >15% over baseline or >500 msec after 2-3 hours of first dose; 125 mcg PO qd
- If QTc >500 msec after the second does; discontinue the treatment
- CrCl <20 mL/min, QTc <440 msec; contraindicated
Pediatric Dosing
- Safety and effectiveness in pediatric patients has not been established
[Outline]
Renal Dose Adjustment (Based on CrCl)
- CrCl >60 mL/min; 500 mcg PO bid
- CrCl 40-60 mL/min; 250 mcg PO bid
- CrCl 20 - <40 mL/min; 125 mcg PO bid
- Contraindicated in patients; <20 mL/min
Hepatic Dose Adjustment
- Mild to moderate hepatic impairment: No dose adjustments
- Severe hepatic impairment: dose adjustment not defined
See Supplemental Patient Information
- To reduce the risk of induced arrhythmia, patients initiated or re-initiated on this drug should be placed for a minimum of 3 days in a facility that can provide monitoring of CrCl, ECG, and cardiac resuscitation (US Black Box Warning)
- Dofetilide can cause serious ventricular arrhythmias, torsade de pointes type ventricular tachycardia, and polymorphic ventricular tachycardia associated with QT interval prolongation; reduced CrCl or dofetilide drug interactions increases dofetilide plasma concentration
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Bradycardia
- Underlying electrolyte abnormalities
Supplemental Patient Information
- Advise patient on need for compliance with the recommended dosing of dofetilide and the potential for drug interactions, need for monitoring of QTc and renal function to minimize the risk of serious abnormal rhythms
- Advise patient not to double the next dose if dose is missed. Next dose should be taken at the usual time
Pregnancy Category:C
Breastfeeding: Safety unknown. manufacturer advised not to breastfeed an infant if a patient is under treatment.
Pricing data from www.DrugStore.com in U.S.A.
- Tikosyn 500 MCG CAPS [Bottle] (PFIZER U.S.)
60 mcg = $245.99
120 mcg = $479.97 - Tikosyn 250 MCG CAPS [Bottle] (PFIZER U.S.)
60 mcg = $246.98
180 mcg = $719.96 - Tikosyn 125 MCG CAPS [Bottle] (PFIZER U.S.)
60 mcg = $245.15
180 mcg = $714.17
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
