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Topic: Dofetilide

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	Dofetilide - Wikipedia, the free encyclopedia
		Dofetilide is a class III antiarrhythmic agent that is approved by the FDA for the maintenance of sinus rhythm in individuals prone to the formation of atrial fibrillation and flutter, and for the chemical cardioversion to sinus rhythm from atrial fibrillation and flutter.
		The elimination half-life of dofetilide is roughly 10 hours, however this is variable based on many physiologic factors (most significantly creatinine clearance), and ranges from 4.8 to 13.5 hours.
		80% of dofetilide is excreted by the kidneys, so the dose of dofetilide should be adjusted in individuals with renal insufficiency, based on creatinine clearance.
	en.wikipedia.org /wiki/Dofetilide (648 words)

	British Journal of Pharmacology - Tedisamil and dofetilide-induced torsades de pointes, rate and potassium dependence (Site not responding. Last check: 2007-10-09)
		Dofetilide is known to prolong the QT interval of the ECG and precipitate torsades de pointes in experimental animals (Buchanan et al., 1993; Bril et al., 1996) and man (Frost et al., 1997; Torp-Pedersen et al., 1999).
		Both dofetilide and tedisamil exacerbated this effect and QT intervals were prolonged in a concentration- and reverse rate-dependent fashion relative to vehicle control (Figure 1).
		Both dofetilide and tedisamil exacerbated this phenomenon and QT intervals were prolonged in a reverse rate-dependent fashion (Figure 5).
	www.nature.com /bjp/journal/v132/n7/full/0703967a.html (4914 words)

	Dofetilide - AFF
		Dofetilide is a class III antiarrhythmic drug, which produces its antiarrhythmic actions by blocking a particular potassium current in the heart.
		The trials showed that, on balance, dofetilide did not increase mortality in either of these two patient groups, and during follow-up the patients were less likely to be in atrial fibrillation, and also less likely to be readmitted to hospital with congestive heart failure.
		The principle risk associated with dofetilide use is that it may produce a new ventricular arrhythmia, called torsades de pointes, in approximately 2% of patients taking the drug.
	www.affacts.org /Medications/dofetilide.html (682 words)

	dofetilide of Augusta, Georgia
		In some patients treated with dofetilide for atrial fibrillation, dofetilide may cause a different type of abnormal heartbeat that can be dangerous, and in rare instances can even cause death.
		Dofetilide is available only from hospitals and doctors who have received special training.
		Dofetilide is in the FDA pregnancy category C. This means that it is not known whether it will harm an unborn baby.
	www.universityhealth.org /16213.cfm (1794 words)

	Dofetilide for Atrial Fibrillation/Flutter (Site not responding. Last check: 2007-10-09)
		Dofetilide selectively blocks the cardiac delayed rectifier potassium current, which more specifically is the rapid component of the current.
		Dofetilide for the FDA approved indication of treatment for atrial fibrillation/atrial flutter is considered medically necessary if the medical appropriateness criteria are met.
		Indications/uses of dofetilide considered investigational are based on a lack of drug approval for those indications and a lack of scientific evidence supporting safety and efficacy in those situations.
	www.bcbst.com /MPManual/Dofetilide_(Tikosyn).htm (629 words)

	MedlinePlus Drug Information: Dofetilide
		Dofetilide comes as a capsule to take by mouth.
		Dofetilide controls abnormal heart rhythms but does not cure them.
		Your heart rhythm should be checked regularly to determine your response to dofetilide.
	www.nlm.nih.gov /medlineplus/druginfo/medmaster/a601235.html (602 words)

	Dofetilide - Drugs & Vitamins - Drug Library - DrugDigest
		DOFETILIDE (Tikosyn®) is a medicine that is given to patients with atrial fibrillation (irregular heartbeats).
		Because your condition and the use of dofetilide carry some risk, it is a good idea to carry an identification card, necklace or bracelet with details of your condition, medications, and prescriber or health care professional.
		It is very important that you take your medication exactly as prescribed when you leave the hospital since the correct dosing of dofetilide is very important to effectively treat your heart rhythm and prevent possible serious side effects.
	www.drugdigest.org /DD/DVH/Uses/0,3915,775\|Dofetilide,00.html (898 words)

	A guide to recently approved cardiovascular medications
		Summary Dofetilide may cause potentially fatal torsade de pointes in a small percentage of patients, but it may be particularly useful in those with both left ventricular dysfunction (LV) and AF, a patient population in which previous trials have shown increased mortality rates with other antiarrhythmics.
		Dofetilide appears to have less noncardiac toxicity and fewer adverse effects on heart rate and BP than the previously available class III agents, amiodarone and sotalol.
		Dofetilide in patients with congestive heart failure and left ventricular dysfunction: Danish Investigations of Arrhythmia and Mortality on Dofetilide Study Group.
	www.jaapa.com /issues/j20040201/articles/0204wcardiomeds.html (2337 words)

	UpToDate Clinical use of dofetilide
		— Dofetilide is one of several methanesulfonamide compounds that has relative selectivity at 10 to 30 nanomol/L for blocking the rapidly-activating component of the delayed rectifier potassium current (IKr) [2,3].
		Purkinje fibers from female dogs are more sensitive to dofetilide than fibers from male dogs, which is consistent with the increased risk of torsade de pointes in women [5].
		Dofetilide is completely absorbed after oral administration, and bioavailability ranges from 75 to 100 percent [8].
	patients.uptodate.com /topic.asp?file=carrhyth/51339 (504 words)

	Dofetilide -- Mounsey and DiMarco 102 (21): 2665 -- Circulation
		Dofetilide reduces the incidence of ventricular fibrillation during acute myocardial ischaemia: a randomised study in pigs.
		Intravenous dofetilide, a class III antiarrhythmic agent, for the termination of sustained atrial fibrillation or flutter: Intravenous Dofetilide Investigators.
		Dofetilide in patients with left ventricular dysfunction and either heart failure or acute myocardial infarction: rationale, design, and patient characteristics of the DIAMOND studies: Danish Investigations of Arrhythmia and Mortality ON Dofetilide.
	circ.ahajournals.org /cgi/content/full/102/21/2665 (4167 words)

	IngentaConnect Dofetilide: a class III anti-arrhythmic drug for the treatment of... (Site not responding. Last check: 2007-10-09)
		Dofetilide is a class III anti-arrhythmic drug that has been approved for the treatment of atrial fibrillation.
		Dofetilide is an option when persistent atrial fibrillation is a clinical problem.
		In the setting of severe heart failure and large myocardial infarctions, only amiodarone and dofetilide have proven safety and dofetilide is a strong candidate for first choice treatment when the aim is to achieve sinus rhythm.
	www.ingentaconnect.com /content/apl/eid/2000/00000009/00000011/art00016 (347 words)

	Molecular Determinant of High-Affinity Dofetilide Binding to HERG1 Expressed in Xenopus Oocytes: Involvement of S6 ...
		Dofetilide is effective in the treatment of a range of cardiac arrhythmias in humans.
		The IC for block by dofetilide was 32 ± 3 µM, which was not grossly different than is observed for the individual mutations [S631A (20 ± 3 µM) or for F656V (15 ± 3 µM)].
		the S631A mutation decreased the affinity for dofetilide to 21
	molpharm.aspetjournals.org /cgi/content/full/57/2/367 (6202 words)

	Dofetilide -- Facts, Info, and Encyclopedia article (Site not responding. Last check: 2007-10-09)
		It is this selective action on accessory pathways that makes dofetilide effective in the treatment of (Fibrillation of the muscles of the atria of the heart) atrial fibrillation and flutter.
		(additional info and facts about Torsades de pointes) Torsades de pointes is the most serious side effect of dofetilide therapy.
		Based on the results of the Danish Investigations of Arrhythmias and Mortality on Dofetilide (DIAMOND) study, dofetilide does not effect mortality in the treatment of patients post- (Destruction of heart tissue resulting from obstruction of the blood supply to the heart muscle) myocardial infarction with (additional info and facts about left ventricular) left ventricular dysfunction.
	www.absoluteastronomy.com /encyclopedia/d/do/dofetilide.htm (508 words)

	Dofetilide (Systemic) - MayoClinic.com
		Dofetilide produces its helpful effects by slowing nerve impulses in the heart.
		It is not known whether dofetilide passes into breast milk.
		Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of dofetilide in children less than 18 years of age with use in other age groups.
	www.mayoclinic.com /health/drug-information/DR500068 (1001 words)

	Dofetilide (Tikosyn Ô) Fact Sheet (Site not responding. Last check: 2007-10-09)
		Dofetilide is excreted in the urine, largely as unmetabolized drug.
		Verapamil is contraindicated due to increased absorption of dofetilide (increases dofetilide concentrations by 42%).
		To initiate therapy with dofetilide, patients must be hospitalized for a minimum of 72 hours with continuous ECG monitoring and personnel trained in the management of serious ventricular arrhythmias.
	www.hopkinsmedicine.org /pharmacy/pharmacists/druginfo/dofetilide.htm (2233 words)

	IngentaConnect Effects of dofetilide on cardiovascular tissues from normo- and h... (Site not responding. Last check: 2007-10-09)
		At a higher more physiological frequency, 4 Hz, the threshold concentration of dofetilide required to augment the force responses of 21-month-old SHR left ventricles was markedly increased and the maximum augmenting effect was decreased.
		In summary, dofetilide is a positive inotrope and negative chronotrope in the rat.
		However, as the positive inotropic effect is not observed with clinically relevant concentrations at a physiological rate in heart failure, dofetilide is unlikely to be useful as a positive inotrope in the treatment of heart failure.
	www.ingentaconnect.com /content/rpsgb/jpp/2002/00000054/00000005/art00014 (322 words)

	CERTs.Article Archive.2001.04.30
		Dofetilide is a new prescription drug that was introduced to the market in 2000 for treating 2 abnormal heart rhythms, atrial fibrillation and atrial flutter.
		In addition, once the person is discharged from the hospital, he or she can obtain more dofetilide only from 1 national mail-order pharmacy.
		The preliminary results indicate that most providers believe that the program is necessary for the safe prescribing of dofetilide and that the potential risks from dofetilide justify the time and resources for the program.
	www.certs.hhs.gov /whats_new/archive/2001/20010430_01.html (384 words)

	Research Activities, March 2004: Pharmaceutical Research: Researchers examine physician prescribing of closely ...
		Both dofetilide and a brand of sotalol, Betapace AF, were approved specifically for treatment of atrial fibrillation or atrial flutter by the U.S. Food and Drug Administration (FDA) in 2000.
		On the other hand, the comparatively smaller number of patients receiving dofetilide versus sotalol suggests that fewer physicians are willing to select dofetilide as opposed to sotalol because of the constraints of the risk-management program, conclude these investigators.
		A higher number of patients in the dofetilide group compared with the sotalol group received the recommended baseline tests for potassium (100 vs. 82 percent), magnesium (89 vs. 38 percent), serum creatinine (100 vs. 82 percent), and electrocardiography (94 vs. 67 percent).
	www.ahrq.gov /research/mar04/0304RA9.htm (786 words)

	Dofetilide Reported Safe And Effective In Treating Cardiac Arrhythmia (Site not responding. Last check: 2007-10-09)
		Dofetilide was developed to target AF and the studies reported this week support the patient benefits that come from restoration of normal cardiac rhythm.
		The safety findings are in marked contrast to several previous trials with other cardiac arrhythmia agents which were shown to increase mortality rates or have very serious side effects compared with placebo.
		Researchers from an American AF trial said two-thirds of those patients treated with dofetilide maintained normal cardiac (or sinus) rhythm for a full year compared with one-quarter of those patients treated with placebo.
	www.docguide.com /dg.nsf/PrintPrint/2AECC2A0D39C22CD8525654E005034D5 (481 words)

	MedlinePlus Drug Information: Dofetilide (Systemic) (Site not responding. Last check: 2007-10-09)
		Dofetilide (DOH–fet–a–lyed) belongs to the group of medicines known as antiarrhythmics.
		However, studies in animals have shown that dofetilide causes birth defects.
		Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of dofetilide in children less than 18 years of age with use in other age groups.
	www.nlm.nih.gov /medlineplus/druginfo/uspdi/500068.html (1000 words)

	Dofetilide
		Patients should be readmitted for continuous monitoring if dosage is later increased.
		If you have an allergy to dofetilide or any other part of the medicine.
		Dofetilide tries to normalize the heartbeats by changing the current through the heart.
	www.umm.edu /altmed/ConsDrugs/Dofetilidecd.html (551 words)

	Healthopedia.com - Dofetilide (Oral) (Tikosyn) - Drugs Information, Side Effects, & Interactions
		You should not use this medicine if you have had an allergic reaction to dofetilide, or if you are using cimetidine (Tagamet®), trimethoprim (Proloprim®), trimethoprim with sulfamethoxazole (Bactrim®, Septra®), ketoconazole (Nizoral®), verapamil (Calan®), prochlorperazine (Compazine®), or megestrol (Megace®).
		You may need to carry identification that says you are using dofetilide.
		If you are treated by a different health care provider, or go to a hospital, tell them you are using dofetilide and give them a list of all medicines and supplements you use.
	www.healthopedia.com /drugs/quick/dofetilide (550 words)

	Molecular Determinants of Dofetilide Block of HERG K+ Channels -- Ficker et al. 82 (3): 386 -- Circulation Research (Site not responding. Last check: 2007-10-09)
		dofetilide blocks BEAG from the cytoplasmic side of the membrane.
		B, Concentration-dependent dofetilide block of CHMs in S5-S6 linker region.
		Concentration-dependent dofetilide block of point mutations in position HERG 619/620 and BEAG 432/443.
	circres.ahajournals.org /cgi/content/full/82/3/386 (6911 words)

	Influence of Dofetilide on QT-Interval Duration and Dispersion at Various Heart Rates During Exercise in Humans -- ... (Site not responding. Last check: 2007-10-09)
		Dofetilide plasma concentrations were measured four times during
		doses of dofetilide in 18 patients with coronary artery disease.
		Fananapazir L, Cropp A. Dofetilide (UK 68,798) prevents ventricular tachycardia on Holter and inducible sustained ventricular tachycardia in patients with hypertrophic cardiomyopathy.
	circ.ahajournals.org /cgi/content/full/94/7/1592 (4026 words)

	Phase IV Trial Evaluating the Effectiveness and Safety of Dofetilide -- Guanzon and Crouch 38 (7): 1142 -- The Annals ...
		AFF with dofetilide is at least comparable to premarketing studies, with
		and megestrol because of altered dofetilide serum concentrations.
		Efficacy and safety of oral dofetilide in converting to and maintaining sinus rhythm in patients with chronic atrial fibrillation or atrial flutter: the symptomatic atrial fibrillation investigative research on dofetilide (SAFIRE-D) study.
	www.theannals.com /cgi/content/full/38/7/1142 (2523 words)

	Efficacy and Safety of Oral Dofetilide in Converting to and Maintaining Sinus Rhythm in Patients With Chronic Atrial ...
		Efficacy and Safety of Oral Dofetilide in Converting to and Maintaining Sinus Rhythm in Patients With Chronic Atrial Fibrillation or Atrial Flutter : The Symptomatic Atrial Fibrillation Investigative Research on Dofetilide (SAFIRE-D) Study -- Singh et al.
		with dofetilide were achieved in 24 hours and 91% in 36 hours.
		The effect of the dosing algorithm on maintenance of SR was examined.
	circ.ahajournals.org /cgi/content/full/102/19/2385 (4054 words)

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