Tikosyn Capsule: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Tikosyn Capsule, generically called dofetilide, is a Class III antiarrhythmic medicine used to treat irregular heartbeats such as atrial fibrillation and atrial flutter. It works by blocking a potassium channel in the heart to help restore and maintain a normal rhythm. Treatment must be started in a hospital because of the risk of a serious abnormal heart rhythm, and doses are carefully adjusted based on kidney function and heart rhythm monitoring.

What is Tikosyn Capsule

Tikosyn is a prescription medicine used to treat an irregular heartbeat. It contains the active ingredient dofetilide and belongs to a group of heart rhythm medicines called Class III antiarrhythmics.

Tikosyn Capsule uses

• Treats irregular heartbeat (atrial fibrillation or atrial flutter)
• Converts atrial fibrillation and atrial flutter to a normal heart rhythm
• Helps maintain a normal heart rhythm after conversion in people with atrial fibrillation or atrial flutter

Benefits of Tikosyn Capsule

• Can convert atrial fibrillation or atrial flutter back to a normal heart rhythm
• Can help delay the return of atrial fibrillation or atrial flutter after the heart rhythm has been restored to normal
• Helps maintain normal sinus rhythm
• Used for certain cases of atrial fibrillation
• Used for atrial flutter

How Tikosyn Capsule works

Tikosyn works by blocking a particular potassium channel in the heart, which helps control the heart's electrical signals. This action lengthens the heart muscle's resting period after each heartbeat, which helps stop or prevent the irregular rhythms of atrial fibrillation and atrial flutter.

Tikosyn Capsule dosage

Take this medicine exactly as your doctor tells you, and do not change your dose unless your doctor tells you to. Treatment must be started in a hospital where your heart rhythm and kidney function are checked for the first few days. It can be taken with or without food. Do not stop taking it until your doctor tells you to stop. If you miss a dose, take the next dose at your usual time — do not take two doses at the same time to make up for it. Your doctor will do tests before you start and periodically while you take this medicine to check your kidney function and heart rhythm.

Available forms and strengths

Capsule (125 mcg, 250 mcg, and 500 mcg strengths)

Side effects of Tikosyn Capsule

Common

• Headache
• Chest pain
• Dizziness
• Respiratory tract infection
• Trouble breathing
• Nausea

Serious

• Torsade de Pointes (a dangerous abnormal heartbeat that can be fatal)
• Other serious ventricular arrhythmias, including ventricular fibrillation and ventricular tachycardia
• Signs of electrolyte imbalance such as severe diarrhea, unusual sweating, vomiting, loss of appetite, or increased thirst
• Allergic reaction, including swelling of the face, lips, tongue, or throat and trouble breathing

Warnings and precautions

• Tikosyn can cause a serious, potentially fatal abnormal heart rhythm called Torsade de Pointes. Because of this risk, treatment must begin in a hospital so your heart rhythm and kidney function can be closely monitored for the first several days.
• This medicine must not be taken with certain other drugs — including cimetidine, verapamil, ketoconazole, trimethoprim (alone or with sulfamethoxazole), prochlorperazine, megestrol, dolutegravir, or hydrochlorothiazide — because they can raise Tikosyn levels in the blood and increase the risk of dangerous heart rhythm problems.
• Low potassium or magnesium levels can increase the risk of dangerous heart rhythms while taking this medicine, so blood potassium must be kept in the normal range before and during treatment.
• Taking this medicine with other drugs that also prolong the QT interval, such as certain antidepressants, antipsychotics, and some antibiotics, is not recommended because it increases the risk of dangerous heart rhythms.
• It is not known if Tikosyn is safe during pregnancy. It should only be used in pregnancy if the benefit to the mother outweighs potential risks to the baby, since animal studies showed harm to the fetus.
• Women should not breastfeed while taking Tikosyn, since it is not known whether the drug passes into breast milk.
• Tikosyn is removed from the body by the kidneys, so people with kidney problems need their dose carefully adjusted, and those with severe kidney impairment or on dialysis should not take it.
• People with mild to moderate liver problems do not need an extra dose adjustment beyond what is based on kidney function, but those with severe liver problems have not been studied and should use this medicine with particular caution.
• There are no known direct interactions between Tikosyn and alcohol, but alcohol may worsen the dizziness this medicine can cause.
• Avoid driving if dizziness or faintness occurs.

Storage

• Store between 59° to 86°F (15° to 30°C)
• Keep away from moisture and humidity
• Keep in a tightly closed container
• Keep out of the reach of children

When to see a doctor

• Call your doctor and go to the hospital right away if you feel faint, become dizzy, or have a fast heartbeat.
• Call your doctor right away if you notice signs of electrolyte imbalance such as severe diarrhea, unusual sweating, vomiting, loss of appetite, or increased thirst.
• If you think you have taken too much of this medicine, call your doctor or go to the nearest hospital emergency room right away, and bring your capsules with you.

Alternatives

• Amiodarone
• Flecainide
• Dronedarone