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Precautions and Warnings With Dofetilide

Make sure your healthcare provider knows if you have kidney problems or a history of low electrolytes, as these problems may prevent you from safely taking dofetilide. Other warnings and precautions with this drug include risks for potentially dangerous drug interactions, life-threatening heart rhythm problems, and other complications that you should review with your healthcare provider before beginning treatment.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking dofetilide (Tikosyn®) if you have:
 
  • Kidney disease, such as kidney failure (renal failure)
  • Liver disease, such as hepatitis, cirrhosis, or liver failure
  • A heart problem known as QT prolongation or long QT syndrome
  • Been told you have low blood potassium or magnesium levels
  • Heart rhythm problems other than atrial fibrillation or atrial flutter
  • Any allergies, including to foods, dyes, or preservatives.
 
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
 
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
 

Specific Dofetilide Precautions and Warnings

Some warnings and precautions to be aware of prior to taking this drug include the following:
 
  • Dofetilide can cause serious heart rhythm problems, including a potentially life-threatening problem known as torsades de pointes (TDP). Because of this risk, dofetilide must be started in the hospital, where your healthcare provider will monitor your kidneys and heartbeat for three days to determine the best dofetilide dosage for you. Seek immediate medical attention if you experience any signs of an abnormal heartbeat, such as:
 
    • Dizziness
    • Lightheadedness
    • Fainting
    • A fast heartbeat.
 
  • Your healthcare provider will monitor your kidneys and heart rate at least every three months during treatment to determine if your dose needs to be adjusted. Make sure to keep all of your lab and healthcare provider appointments.
 
  • Low electrolyte levels, specifically low blood potassium or magnesium, can increase the risk for torsades de pointes. Your healthcare provider will check your electrolytes using a simple blood test before starting dofetilide, and periodically during treatment. Let your healthcare provider know if you experience any signs of an electrolyte imbalance, such as:
 
    • Severe diarrhea
    • Sweating
    • Vomiting
    • Loss of appetite
    • Increased thirst.
 
  • It is unknown whether dofetilide is safe for use in people with severe liver disease. Therefore, the medication should be used cautiously in these people.
 
 
  • Dofetilide is a pregnancy Category C medication. This means that it may not be safe for use during pregnancy (see Tikosyn and Pregnancy).
 
  • It is unknown whether dofetilide passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Tikosyn and Breastfeeding).
 
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Dofetilide Medication Information

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