Drug interactions
Dofetilide + Lithium
Severity: Major
Dofetilide and Lithium: 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 strongly prolongs the QT interval and carries a high risk of torsades de pointes. Lithium's additional effects on repolarization and its potential for sinus node dysfunction add to the risk.
What this interaction means in plain words
Dofetilide and Lithium 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; Lithium belongs to Central Nervous System.
Why it happens
Additive pharmacodynamic QT prolongation on top of dofetilide's potassium channel blockade.
What to do
Avoid the combination where possible. If used, initiate dofetilide under inpatient ECG monitoring, keep electrolytes normal, and monitor lithium levels and renal function.
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
Other interactions of Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium 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 Lithium?
MediHelp rates the interaction as major. Dofetilide and Lithium 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 strongly prolongs the QT interval and carries a high risk of torsades de pointes. Lithium's additional effects on repolarization and its potential for sinus node dysfunction add to the risk.
How serious is the interaction between Dofetilide and Lithium?
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 where possible. If used, initiate dofetilide under inpatient ECG monitoring, keep electrolytes normal, and monitor lithium levels and renal function.
What other medicines interact with Lithium?
MediHelp also lists interactions of Lithium with, for example, Thioridazine, Vandetanib, Aceclofenac. The full list is on the Lithium page.
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