Tikosyn, or dofetilide, is very specifically prescribed to maintain normal sinus rhythm in patients suffering from atrial fibrillation (sustained high heart rate) who have been successfully converted back to normal sinus rhythm. This medication carries numerous side effects, the most serious of which affect the cardiovascular and central nervous systems. Several drug-to-drug side effects carrying life-threatening complications are also possible; patients are advised to read the package inserts for Tikosyn. Patients taking this medication must also take it at the same time every day to maintain normal sinus rhythm.
Abnormal Heart Rhythms
Ventricular fibrillation, ventricular tachycardia and torsades de pointes (all abnormal, fast heart rates) are serious and life-threatening heart rhythms that are possible side effects of Tikosyn therapy. A patient experiencing these abnormal rhythms can feel his heart beating irregularly and typically complains that he feels as though his heart is "beating out of his chest." The patient or a family member should immediately call 911 and be transported to the nearest medical facility. These rhythms may be preceded by sweating, palpitations, chest pain and an overall sudden feeling of malaise or dizziness.
Other possible and serious cardiovascular side effects may include heart block, bradycardia (slow heart rate), cardiac arrest and myocardial infarction (heart attack). A patient experiencing sudden, sharp and sustained chest pain, confusion and sweating should seek immediate medical attention.
It is also possible that a patient taking Tikosyn may slip back into atrial fibrillation. The patient should notify his primary health care provider and seek medical attention.
Higher Risk of Stroke
Tikosyn therapy carries an increased risk of stroke. A patient who suddenly experiences confusion, inability to speak, slurred or unintelligible speech, drooping of the face or eyelid, weakness or paralysis on one side, sudden and severe headache, or vision loss should be immediately transported to the nearest medical facility and her primary physician should be notified.
Angioedema
A serious, but sometimes difficult to defect, side effect of Tikosyn therapy is angioedema (increased fluid in a blood vessel). Characterized by a swelling of the mucous membranes, skin or internal organs, angioedema may manifest on the skin in the benign form of hives, or cause respiratory distress when present in the airways. This side effect usually manifests as a result of an allergy to Tikosyn and is treatable with medications. The patient should not attempt to treat the condition with an anti-allergy medication, as this side effect may quickly become life-threatening. A patient experiencing shortness of breath or pain when breathing should call 911 and be transported to the nearest medical facility for further evaluation.
References
- "PDR Nurse's Drug Handbook 2010;" Thomson Reuters and Alexander Ivy; 2009
- "Pathophysiology: A 2-in-1 Reference for Nurses;" Lippincott Williams & Wilkins; 2005
- "Mosby's 2010 Nursing Drug Reference;" Linda Skidmore-Roth, 2009
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