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Tikosyn

Generic name: dofetilide
Dosage form: oral capsule
Drug class: Group III antiarrhythmics

Medically reviewed by Philip Thornton, DipPharm. Last updated on Aug 23, 2023.

What is Tikosyn?

Tikosyn (dofetilide) is an antiarrhythmic drug that is used to treat an abnormal heartbeat. Antiarrhythmic drugs are classified using a system known as the Vaughan Williams Classification System and under this system Tikosyn is classed as a Class III antiarrhythmic, which is a group of drugs that act as potassium channel blockers.

Tikosyn works by blocking specific potassium channels called inward-rectifier potassium channels (IKr) in the heart. This increases the effective refractory period (ERP) - or resting period - that occurs after a heart muscle cell (cardiac myocyte) has responded to the electrical charge (action potential). Increasing the amount of time a cell rests for helps to prevent certain types of arrhythmias.

Tikosyn was first approved by the US Food and Drug Administration (FDA) on 1 October 1999. Generic versions of this medication are also available.

What is Tikosyn used for?

Tikosyn is a prescription medicine that is used to treat an irregular heartbeat (atrial fibrillation or atrial flutter).

It is not known if this medication is safe and effective in children under 18 years of age.

Tikosyn has also been used 'off-label' in patients with supraventricular arrhythmias, ventricular tachycardia, and Wolff-Parkinson-White syndrome.

Important information

Tikosyn can cause serious side effects, including a type of abnormal heartbeat called Torsade de Pointes, which can lead to death.

To establish the right dose of this medication, treatment with Tikosyn must be started in a hospital where your heart rate and kidney function will be checked for the first 3 days of treatment. It is important that when you go home, you take the exact dose of Tikosyn that your doctor prescribed for you.

While you take this medication, always watch for signs of abnormal heartbeat.

Call your doctor and go to the hospital right away if you:

Who should not take Tikosyn?

Do not take Tikosyn if you:

What should I tell my doctor before taking Tikosyn?

Before taking Tikosyn, tell your doctor about all of your medical conditions including if you:

Especially tell your doctor if you take medicines to treat:

Ask your doctor if you are not sure about the medicines you take.

How should I take Tikosyn?

What happens if I miss a dose?

If you miss a dose of Tikosyn, just take the next dose at your regular time. Do not take 2 doses of this medication at the same time.

What happens if I overdose?

If you take too much Tikosyn, call your doctor or go to the nearest hospital emergency room right away. Take your capsules with you to show to the doctor.

Dosing information

The usual recommended dose of Tikosyn is 500 mcg taken orally twice a day, but this dose may need to be modified using the dosing algorithm supplied in the full prescribing information.

The dose of this Tikosyn must be individualized according to calculated creatinine clearance and QTc (corrected for heat rate). QT interval should be used if the heart rate is <60 beats per minute. There are no data on use of this medication when the heart rate is <50 beats per minute.

See the full prescribing information for further details about Tikosyn dosing.

amiodarone, lidocaine, verapamil, dofetilide, Pacerone, mexiletine

What are the side effects of Tikosyn?

Tikosyn can cause serious side effects, including a type of abnormal heartbeat called Torsade de Pointes, which can lead to death. See 'Important information' above.

The most common side effects of Tikosyn include:

Call your doctor right away if you have signs of electrolyte imbalance including:

Tell your doctor if you have any side effects that bother you or do not go away.

These are not all the possible side effects of this medication. For more information, ask your doctor or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Interactions

Tell your healthcare provider about all the medicine you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Tikosyn and other medicines may affect each other, causing serious side effects. If you take Tikosyn with certain medicines, you will be more likely to have a different type of abnormal heartbeat. See "Who should not take Tikosyn?" above for a list of medications.

Know the medicines you take. Keep a list of your medicines and show it to your doctor and pharmacist when you get a new medicine.

Does Tikosyn interact with my other drugs?

Enter medications to view a detailed interaction report using our Drug Interaction Checker.

Pregnancy and breastfeeding

Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known if Tikosyn will harm your unborn baby.

Tell your healthcare provider if you are breast-feeding or plan to breast-feed. It is not known if Tikosyn passes into your breast milk. You and your doctor should decide if you will take this medication or breastfeed. You should not do both.

Storage

What are the ingredients in Tikosyn?

Active ingredient: dofetilide

Inactive ingredients:

Capsule fill: microcrystalline cellulose, corn starch, colloidal silicon dioxide, and magnesium stearate

Capsule shell: gelatin, titanium dioxide, and FD&C Yellow 6

Imprinting ink: iron oxide black, shellac, n-butyl alcohol, isopropyl alcohol, propylene glycol, and ammonium hydroxide

Tikosyn is distributed by Pfizer Labs, Division of Pfizer Inc, NY, NY10017.

Popular FAQ

How long can you stay on Tikosyn?

How long you take Tikosyn for depends on your renal or kidney function and whether or not this medication prolongs your QT interval. Your QT interval is the amount of time it takes for the chambers (ventricles) in your heart to contract and relax then start this process over again. If Tikosyn prolongs your QT interval then you will need to stop taking it because this can increase your risk of developing another arrhythmia or abnormal heartbeat. If your renal function deteriorates and you develop severe renal impairment then treatment with Tikosyn will also need to be stopped. Continue reading

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.