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Dofetilide: Dosing & Side Effects

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

This lesson briefly defines a drug called dofetilide and its major use. It then goes over the dosage information related to this medication and this information's precautions. Finally, you'll learn about some of its many potential side-effects.

Dofetilide

Do you know what the most common sustained heart arrhythmia is? It's called atrial fibrillation. Elderly individuals are particularly likely to have it compared to the young. One of the possible treatments for this arrhythmia, as well as another one called atrial flutter, is called dofetilide. Dofetilide is classed as an antiarrhythmic medication because it seeks to restore the heart's normal sinus rhythm.

Let's learn about its general dosage information and side effects in this lesson.

Dosage Information

It's important to note right away, that a correct dose and dosage regimen must be established by a medical professional for this medication. One very good reason for this is because if it's dosed improperly, it can actually lead to the development of other irregular heartbeats!

Another very critical point when it comes to figuring out the correct dose is the patient's kidney function. For example, people with compromised kidney function will require lower doses than those with otherwise healthy kidneys. One way to measure and assess kidney function is to compare the values of a substance called creatinine in blood vs. urine. A test called the creatinine clearance (CrCl) test can measure this. If the values from the test are high enough, a higher dose can be given safely than if the values are low.

And so, to convert atrial fibrillation or atrial flutter to a normal sinus rhythm, the following INITIAL doses might be used:

  • If CrCl is >60 mL/min, then a dose of 500 mcg is taken by mouth, every 12 hours.
  • If CrCl is 40-60 mL/min, then a dose of 250 mcg is taken by mouth, every 12 hours.
  • If CrCl is 20-40 mL/min, then a dose of 125 mcg is taken by mouth, every 12 hours.
  • If CrCl is <20 mL/min, then this medication should be avoided if possible.

This dose is also based on exactly how long a certain heart rhythm interval, the QT interval, actually is. In other words, if the QT interval is too long (greater than 440-500 msec in length), the person should not be given dofetilide.

Can you see why you shouldn't try and dose this medication on your own? It's not easy, and it can spell serious trouble if you try and wing it without proper testing prior to its use.

Side Effects

This drug has numerous potential side effects, some of which include:

  • Headache
  • Dyspnea, or shortness of breath
  • Nausea
  • Chest pain
  • Stomach pain
  • Back pain
  • Insomnia
  • Flu-like symptoms

In very rare cases, a person may have an allergic reaction to this medication and may experience any combination of the following:

  • Rash
  • Vomiting
  • Diarrhea
  • Dizziness
  • A fast and pounding heartbeat
  • Swelling of the lips, throat, tongue, or face

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