Drug interactions
Dofetilide + Ranolazine
Severity: Major
Dofetilide and Ranolazine: 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
Both drugs prolong the QT interval, and ranolazine also inhibits the renal transport of dofetilide and may raise its levels. This can increase the risk of torsades de pointes.
What this interaction means in plain words
Dofetilide and Ranolazine 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; Ranolazine belongs to Cardiovascular.
Why it happens
Additive QT prolongation, with possible reduced renal clearance of dofetilide.
What to do
Avoid the combination where possible. If it is used, start dofetilide in a monitored setting with continuous ECG and adjust the dose by QTc 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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine Contraindicated
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 Ranolazine?
MediHelp rates the interaction as major. Dofetilide and Ranolazine 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. Both drugs prolong the QT interval, and ranolazine also inhibits the renal transport of dofetilide and may raise its levels. This can increase the risk of torsades de pointes.
How serious is the interaction between Dofetilide and Ranolazine?
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 it is used, start dofetilide in a monitored setting with continuous ECG and adjust the dose by QTc and renal function.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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