Tikosyn Interactions: Comprehensive Guide on Drugs, Supplements, and More
Discover how Tikosyn (dofetilide) interacts with various medications, supplements, foods, and other factors. Learn important precautions to ensure safe and effective treatment of arrhythmias.
Tikosyn (dofetilide) is a prescription medication in capsule form, primarily used to manage atrial fibrillation (AFib) and atrial flutter—two common types of irregular heart rhythms—in adults. It is crucial to understand how Tikosyn may interact with other drugs, supplements, and lifestyle factors to avoid adverse effects and optimize treatment outcomes.
Can Tikosyn Interact with Other Medications?
Drug interactions occur when one substance alters the effects of another, potentially leading to unexpected or harmful outcomes. These interactions can also be influenced by pre-existing health conditions.
Before initiating Tikosyn therapy, inform your healthcare provider and pharmacist about all prescription medicines, over-the-counter drugs, supplements, and herbal products you are using. This information helps prevent harmful interactions. For details on herbal and vitamin interactions, refer to the section “Other Interactions with Tikosyn.”
If you have concerns about possible interactions, consult your doctor or pharmacist.
The table below outlines common medications that may interact with Tikosyn. Note that this list is not exhaustive; always seek professional advice for comprehensive information.
| Drug Category | Examples | Potential Effects |
|---|---|---|
| Certain Antibiotics | Azithromycin (Zithromax), Ciprofloxacin (Cipro), Trimethoprim* | Increased risk of Tikosyn side effects |
| Certain Antidepressants | Citalopram (Celexa), Escitalopram (Lexapro), Nefazodone | Heightened risk of Tikosyn adverse effects |
| Certain Antifungals | Fluconazole (Diflucan), Itraconazole (Sporanox), Ketoconazole* | Elevated risk of side effects |
| Selected HIV Medications | Dolutegravir (Tivicay)*, Nelfinavir (Viracept), Ritonavir (Norvir) | Increased side effect risk |
| Specific Diuretics | Furosemide (Lasix), Hydrochlorothiazide (Microzide)*, Triamterene (Dyrenium) | Greater risk of adverse effects |
| Other Antiarrhythmics | Amiodarone (Pacerone), Disopyramide (Norpace), Flecainide | Increased arrhythmia risk |
| Certain Antipsychotics | Aripiprazole (Abilify), Chlorpromazine, Haloperidol (Haldol) | Higher risk of arrhythmia |
| Cimetidine (Tagamet HB)* | — | Increased Tikosyn side effects |
| Megestrol (Megace)* | — | Elevated risk of side effects |
| Prochlorperazine (Compro, Procomp)* | — | Greater risk of adverse effects |
| Verapamil (Verelan)* | — | Increased side effect risk |
* These medications should not be taken concurrently with Tikosyn. For more details, see the “When to Avoid Tikosyn” section.
When Should Tikosyn Be Avoided?
Certain medical conditions and medications increase the risk of harm from Tikosyn, leading to contraindications where the drug should not be prescribed.
Medications to Avoid: The following drugs can cause Tikosyn levels to accumulate dangerously in the body, increasing the risk of severe side effects including life-threatening arrhythmias:
- Cimetidine (Tagamet HB)
- Dolutegravir (Tivicay) and combination therapies containing it (Triumeq, Dovato, Juluca)
- Hydrochlorothiazide (Microzide) and combination drugs containing it (Tribenzor, Exforge HCT, Ziac, Atacand HCT)
- Ketoconazole
- Megestrol (Megace)
- Prochlorperazine (Compro, Procomp)
- Trimethoprim
- Sulfamethoxazole/Trimethoprim (Bactrim, Septra)
- Verapamil (Verelan)
If you are taking any of these, consult your physician about alternative treatments.
Health Conditions:
- Long QT Syndrome: Tikosyn is generally contraindicated due to increased risk of severe arrhythmias.
- Severe Kidney Impairment: Poor kidney function can cause dangerous accumulation of Tikosyn.
- Allergic Reactions: Prior allergic response to Tikosyn or its ingredients precludes its use.
Discuss your medical history thoroughly with your healthcare provider before starting Tikosyn.
Does Alcohol Affect Tikosyn?
While Tikosyn has no known direct interaction with alcohol, both can cause similar side effects such as dizziness, headache, and nausea. Combining alcohol with Tikosyn may amplify these effects. Consult your healthcare provider for personalized advice regarding alcohol consumption during treatment.
Detailed Explanation of Drug Interactions
Antibiotics
Certain antibiotics like azithromycin, ciprofloxacin, clarithromycin, moxifloxacin, and trimethoprim can increase Tikosyn blood levels, raising the risk of side effects including arrhythmia. Both Tikosyn and these antibiotics can prolong the QT interval, heightening the risk of serious heart rhythm disturbances.
Patients with low potassium levels are especially vulnerable to these risks.
Your doctor may avoid prescribing these antibiotics with Tikosyn or adjust dosages accordingly, monitoring heart rhythm and electrolyte levels closely.
Antidepressants
Antidepressants such as citalopram, escitalopram, fluoxetine, and nefazodone may also elevate Tikosyn levels and increase the risk of arrhythmia. Both drug classes can prolong the QT interval, compounding this risk.
Medical supervision is essential, with possible dosage adjustments and monitoring.
Diuretics
Diuretics like furosemide, indapamide, hydrochlorothiazide, and triamterene can affect Tikosyn levels and electrolyte balance, increasing the risk of arrhythmias. Hydrochlorothiazide should not be combined with Tikosyn.
Close monitoring and dosage modifications may be necessary.
Other Potential Interactions
Supplements and Herbs
Inform your healthcare provider about all herbal and vitamin supplements. St. John’s wort, used for depression, can reduce Tikosyn effectiveness and is generally avoided during treatment. No significant interactions with vitamins have been reported yet, but caution is advised.
Food
Avoid grapefruit and grapefruit juice while on Tikosyn, as they can increase drug levels and risk of side effects.
Vaccines and Lab Tests
No known interactions with vaccines or laboratory tests have been reported. Consult your doctor if you have concerns.
Interactions with Cannabis and CBD: Cannabis and cannabidiol (CBD) products may alter Tikosyn levels, affecting its efficacy and safety. Disclose cannabis use to your healthcare providers to prevent adverse interactions. Note that cannabis legality varies by location.
Impact of Medical History on Tikosyn Use
Your health conditions significantly influence Tikosyn suitability:
- Kidney Disease: Impaired clearance can cause drug accumulation; dosage adjustments or alternative treatments may be needed.
- Liver Disease: Safety is unclear; consult your doctor.
- Heart Conditions: Long QT syndrome contraindicates Tikosyn use.
- Pregnancy and Breastfeeding: Safety is not established; discuss risks with your healthcare provider.
- Allergies: Previous allergic reactions to Tikosyn preclude use.
Preventing Tikosyn Interactions
To minimize interaction risks:
- Disclose all medications, supplements, alcohol, and cannabis use to your healthcare team.
- Understand and follow Tikosyn’s prescribing information carefully.
- Report any new medications started during treatment immediately.
- Adhere strictly to prescribed dosages.
Always consult your doctor or pharmacist if you have questions or concerns about Tikosyn interactions.
Disclaimer: This information is intended to support, not replace, professional medical advice. Always consult a licensed healthcare provider before starting or changing any medication.
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