Drug interactions
Dofetilide + Sevoflurane
Severity: Major
Dofetilide and Sevoflurane: major interaction.
Last updated Sources: US FDA label
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 markedly prolongs the QT interval and carries a high torsades de pointes risk. Sevoflurane also lengthens QTc, so the combination may add to this risk during surgery.
What this interaction means in plain words
Dofetilide and Sevoflurane 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; Sevoflurane belongs to Central Nervous System.
Why it happens
Additive prolongation of cardiac repolarization via potassium channel blockade.
What to do
Review baseline QTc and electrolytes pre-operatively and keep potassium and magnesium replete. Monitor ECG continuously and have rhythm-management resources available; consider an alternative anesthetic if QTc is already prolonged.
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 Sevoflurane
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 Sevoflurane?
MediHelp rates the interaction as major. Dofetilide and Sevoflurane 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 markedly prolongs the QT interval and carries a high torsades de pointes risk. Sevoflurane also lengthens QTc, so the combination may add to this risk during surgery.
How serious is the interaction between Dofetilide and Sevoflurane?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Review baseline QTc and electrolytes pre-operatively and keep potassium and magnesium replete. Monitor ECG continuously and have rhythm-management resources available; consider an alternative anesthetic if QTc is already prolonged.
What other medicines interact with Sevoflurane?
MediHelp also lists interactions of Sevoflurane with, for example, Amiodarone, Amisulpride, Arsenic trioxide. The full list is on the Sevoflurane page.
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