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Considerations for Dofetilide Use in the Elderly

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This case describes an 85-year-old African-American female with atrial arrhythmias on dofetilide maintenance therapy who presented to an ambulatory cardiology clinic with hypotension. The pharmacist identified a potential major drugdrug interaction between dofetilide and the thiazide diuretic, chlorthalidone. Because of the patient's hypotension, it was decided to discontinue chlorthalidone to avoid the potential drug interaction with dofetilide. A systolic BP goal of 140-145 mmHg was later achieved and maintained with the addition of low-dose amlodipine, in addition to her lisinopril. This case highlights important considerations for prescribing and monitoring dofetilide and reviews hypertension management in the elderly population.

Keywords: AF = Atrial fibrillation; BP = Blood pressure; CPC = Cardiopharmacotherapy clinic; Chlorthalidone; Diuretics; Dofetilide; Drug interactions; ECG = Electrocardiogram; HCTZ = Hydrochlorothiazide; HTN = Hypertension; IU = International units; PAC = Premature atrial contractions; TdP = Torsades de pointes; Thiazide

Document Type: Research Article


Publication date: 2014-04-01

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  • The Consultant Pharmacist® is the official peer-reviewed journal of the American Society of Consultant Pharmacists. It is dedicated exclusively to the medication needs of the elderly in all settings, including adult day care, ambulatory care, assisted living, community, hospice, and nursing facilities. This award-winning journal is a member benefit of ASCP. Individuals who are not members and wish to receive The Consultant Pharmacist® will want to consider joining ASCP.
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