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Dofetilide - Tikosyn ® - Renal Dosing

Usual Dosing (Adults)

INDICATIONS AND USAGE

Maintenance of Normal Sinus Rhythm (Delay in AF/AFl Recurrence)
TIKOSYN is indicated for the maintenance of normal sinus rhythm (delay in time to recurrence of atrial fibrillation/atrial flutter [AF/AFl]) in patients with atrial fibrillation/atrial flutter of greater than one week duration who have been converted to normal sinus rhythm. Because TIKOSYN can cause life threatening ventricular arrhythmias, it should be reserved for patients in whom atrial fibrillation/atrial flutter is highly symptomatic.

In general, antiarrhythmic therapy for atrial fibrillation/atrial flutter aims to prolong the time in normal sinus rhythm. Recurrence is expected in some patients (see CLINICAL STUDIES).

Conversion of Atrial Fibrillation/Flutter
TIKOSYN is indicated for the conversion of atrial fibrillation and atrial flutter to normal sinus rhythm.

TIKOSYN has not been shown to be effective in patients with paroxysmal atrial fibrillation.



Dosing:
500 mcg po bid initially. May be initiated at lower doses based on physician discretion. QTc interval should be measured 2-3 hours after the initial dose. If the QTc >15% of baseline, or if the QTc is >500 msec (550 msec in patients with ventricular conduction abnormalities), dofetilide should be adjusted. Continued monitoring for doses 2-5: QTc interval must be determined 2-3 hours after each subsequent dose of dofetilide for in-hospital doses 2-5. If the measured QTc is >500 msec (550 msec in patients with ventricular conduction abnormalities) dofetilide should be stopped.

Renal Dosing

dialysis [CRCL >60 ml/min]: 500 mcg bid

[40-60 ml/min]: 250 mcg twice daily.

[20-39 ml/min]: 125 mcg twice daily.

[<20 ml/min]: Contraindicated.

Hemodialysis

dialysis Contraindicated

Reference(s)

National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
Provides access to the latest drug monographs submitted to the Food and Drug Administration (FDA). Please review the latest applicable package insert for additional information and possible updates.  A local search option of this data can be found here.

Disclaimer

The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.   Read the disclaimer
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