Medication Information for Tikosyn® (Dofetilide) Admission

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Why am I going to start dofetilide?

You have atrial fibrillation or atrial flutter that may be causing you problems. Tikosyn, also called dofetilide (generic name), is one of the medications used to try to keep you out of atrial fibrillation.

 

Why do I need to come in to the hospital?

  • Although dofetilide is safe in most people, there are a small number of people who will have an exaggerated electrical effect from this medication. You will be monitored with an EKG (electrocardiogram) while on this medication to make sure this is not happening in your case.

  • If your doctor suspects that you are having this exaggerated effect, your dose will either be reduced or the medication stopped altogether.

  • After five total doses monitored in the hospital, it is safe for you to leave the hospital and continue to take the medicine at home.

 

How do I take dofetilide?

  • Dofetilideis a pill that you take every 12 hours.

  • You must be very careful to take it as close to every 12 hours as possible.

 

What happens if I’m late with a dose?

  • If it’s within one hour of your scheduled time, take it right away and stay on your schedule.

  • If you are late by more than one hour, skip the dose and take the next one as scheduled.

 

What happens if I skip more than one dose?

  • Do not miss more than one dose.

  • If you miss more than one dose, you must stop taking the medication and let your doctor know. You will most likely be readmitted to the hospital to restart the medication, just as you did the first time.

  • Most people set an alarm on their watches, cell phones or home alarm clocks to ring every day at the scheduled times to help them remember.

  • It may help for you to have a pill carrier on your keychain and keep one or two capsules with you at all times.

  • Do not take an extra dose of dofetilide ever.

 

What are the side effects of dofetilide?

  • This medicine is very well tolerated. There are very minimal side effects. Talk to your doctor if you think you are having a side effect from this medicine, as it is rare and unusual.

  • Call your doctor right away or seek emergency help if you feel faint, get dizzy or lightheaded, or have fast or abnormal heartbeat sensation different from your atrial fibrillation.

 

Is there anything I should look out for?

  • Let your doctor know if you have any of the following:

  • Severe diarrhea

  • Heavy, profuse sweating

  • Vomiting

  • Dramatic change in urination (urinating too much or too little).

You MUST get an EKG and blood tests at least every six months, or, in some cases, every three months. Make sure to contact your doctor’s office if it has been longer than six months since your last EKG or blood test.

 

Are there any medicines I should avoid?

Look over the following list of medications carefully. Notify your doctor if you are taking one of these medicines. You should stop these medicines two days before your scheduled hospitalization:

  • Cimetidine (Tagamet®, Tagamet HB®)

  • Verapamil (Calan®, Calan SR®, Covera-HS®, Isoptin®, Isoptin SR®, Verelan®, Verelan PM®, Tarka®)

  • Ketoconazole (Nizoral®, Xolegel®, Extina®)

  • Trimethoprim alone (Proloprim®, Trimpex®) or the combination of trimethoprim and sulfamethoxazole (Bactrim®, Septra®, Sulfatrim®)

  • Prochlorperazine (Compazine®, Compro®)

  • Megestrol (Megace®)

  • Hydrochlorothiazide alone or in combination with other medicines (Esidrix®, Ezide®, Hydrodiuril®, Hydro-Par®, Microzide®, Oretic®)

If you receive any new prescriptions, please make sure the prescribing doctor is aware you are on dofetilide (Tikosyn) to check for drug-drug interactions. If you have any concerns, call Dr. Raphael Sung at 303.398.1355, option 4 before starting the new medications.

 

Can I stop taking blood thinners?

In general, if you were on a blood thinner before starting dofetilide, you should remain on one at all times, even if you believe you are no longer in atrial fibrillation.

 

What will happen during my hospitalization?

  • You will receive an EKG and blood test before your arrival in the hospital.

  • Once you arrive, your hospital team will start you on dofetilide. (It is a capsule.)

  • You will get an EKG two hours after each dose, for a total of five doses.

  • On the third day, you may have a cardioversion (electrical shock) to try to get you out of atrial fibrillation. (In some cases, you will have a cardioversion before starting the medication.)

  • You will go home on the third day. Be sure to follow up with your doctor as scheduled, no later than three months after starting the medicine. Plan to have someone drive you home.

 

Who should I call for more questions?

  • Call our office and ask to speak to the heart rhythm team, including Dr. Sung at 303.398.1355, option 4.

  • Call the pharmacist who dispensed the medication.

  • Call the Tikosyn nursing hotline at 1.877.TIKOSYN (1.877.845.6796).

 

Where can I get this medication?

  • Unfortunately, only a limited number of pharmacies stock this medication. Call your regular pharmacy and ask if they are able to order the medication.

  • In most cases, you will leave the hospital with a 30-day supply of dofetilide in hand. In addition, a prescription will be sent to your home pharmacy.

  • Within one to two weeks after leaving the hospital, please call your home pharmacy and verify that the prescription was received. Call Dr. Sung and his team if there are any questions.
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