Drug interactions
Dofetilide + Donepezil
Severity: Major
Dofetilide and Donepezil: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Dofetilide causes dose-dependent QT prolongation with a high torsades risk. Donepezil adds further QT liability and can cause bradycardia, making the combination hazardous.
What this interaction means in plain words
Dofetilide and Donepezil can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Dofetilide belongs to Cardiovascular; Donepezil belongs to Central Nervous System.
Why it happens
Additive prolongation of repolarization; dofetilide blocks the IKr potassium current.
What to do
Avoid the combination; if dofetilide is required, consider holding donepezil. Dofetilide must be started under continuous ECG monitoring with QTc-guided dosing.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
- Apozyl 10 mg Orodispersible Tablets - SmPC sections 4.3/4.5 (class statement: Class III antiarrhythmics; "Class III antiarrhythmics (e.g. amiodarone, sotalol)") — electronic medicines compendium (UK SmPC)
Other interactions of Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
Other interactions of Dofetilide
- Amiodarone + Dofetilide Contraindicated
- Amisulpride + Dofetilide Contraindicated
- Amlodipine-hydrochlorothiazide-valsartan + Dofetilide Contraindicated
- Amlodipine-olmesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Candesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Captopril-hydrochlorothiazide + Dofetilide Contraindicated
Frequently asked questions
Can I take Dofetilide with Donepezil?
MediHelp rates the interaction as major. Dofetilide and Donepezil can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Dofetilide causes dose-dependent QT prolongation with a high torsades risk. Donepezil adds further QT liability and can cause bradycardia, making the combination hazardous.
How serious is the interaction between Dofetilide and Donepezil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; if dofetilide is required, consider holding donepezil. Dofetilide must be started under continuous ECG monitoring with QTc-guided dosing.
What other medicines interact with Donepezil?
MediHelp also lists interactions of Donepezil with, for example, Dronedarone, Pimozide, Thioridazine. The full list is on the Donepezil page.
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