Dofetilide: Drug Interactions & Contraindications

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

This lesson is going to briefly define a medication known as dofetilide. You'll learn about some of its many drug interactions and its important contraindications.

What is Dofetilide?

An old-fashioned grandfather clock has a certain rhythm to it, doesn't it? The pendulum swings at a certain rate, and that moves the minute and hour hands of the clock at a certain rate as well. However, sometimes that clock can develop a funky rhythm that would keep the time wrong, wouldn't it? And you'd need to give the clock a tune-up to set things right again.

Our heart also has a certain rhythm to it. The normal rhythm is called a sinus rhythm. As the electrical activity is conducted properly through the heart, the chambers of the heart contract and relax at a certain normal rate. However, our heart can sometimes develop a funky rhythm to it that causes the chambers of the heart to contract and relax at the wrong time. In these cases, we can give our heart a tune-up via one of the numerous antiarrhythmic medications. One such medication is called dofetilide, and it is used to treat atrial fibrillation and atrial flutter, two types of irregular heartbeats.

Let's go over this drug's interactions and contraindications in this lesson. We'll also come back to the clock example in a little bit so don't forget it!

Drug Interactions

Some drugs, when used alongside dofetilide, may pose a danger to a person. Dofetilide has many such drug interactions.

For example, a drug called cimetidine can increase the levels of dofetilide in the body by decreasing the kidney's rate of clearance of dofetilide from the body. In other words, more of the dofetilide sticks around in the body than otherwise should. This can lead to an irregular heart rhythm that can endanger a person's health. By the way, cimetidine is a type of stomach acid reducer.

If a person takes dofetilide with another drug, called amiodarone, then this might spell trouble as well. The problem is that amiodarone is an antiarrhythmic as well. And so, each drug ends up increasing the effects of the other in a synergistic manner, and this can lead to a life-threatening arrhythmia as well.

There are literally hundreds of similar and other interactions between dofetilide and other drugs, including the likes of:

  • Cisapride
  • Astemizole
  • Ibutilide
  • Lidocaine
  • Mexiletine

And many others. Always consult a doctor prior to starting this medication.


Most of the drugs mentioned above are contraindicated in people taking in dofetilide. In other words, the two drugs shouldn't be taken together. Besides drug-based contraindications, dofetilide does have other contraindications. Meaning, a person shouldn't take this drug if the following situations apply.

One is a known hypersensitivity to the medication. In other words, if a person experienced an allergic reaction to this medication, they should not be given it again. That one is obvious.

Another contraindication is severe renal impairment. In other words, severe kidney dysfunction/disease. One of the tests that can assess for this is known as the creatinine clearance test. This test measures the ability of the kidneys to clear a substance called creatinine out of the body. If the creatinine clearance is < 20 mL/min, then dofetilide is contraindicated.

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