Comparative Pharmacology
Head-to-head clinical analysis: CORDARONE versus DOFETILIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CORDARONE versus DOFETILIDE.
CORDARONE vs DOFETILIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Class III antiarrhythmic agent; prolongs action potential duration and refractory period via blockade of potassium channels; also exhibits class I, II, and IV properties including sodium channel blockade, non-competitive beta-adrenergic blockade, and calcium channel blockade.
Selectively blocks the rapid component of the delayed rectifier potassium current (Ikr) in cardiac myocytes, prolonging repolarization and the effective refractory period.
Loading dose: 800-1600 mg/day orally in divided doses for 1-3 weeks, then 600-800 mg/day for 1 month, then maintenance: 200-400 mg/day. IV: Loading 150 mg over 10 minutes, then 1 mg/min for 6 hours, then 0.5 mg/min.
250-500 mcg orally twice daily, based on creatinine clearance and QTc response.
None Documented
None Documented
Clinical Note
moderateDofetilide + Levofloxacin
"Dofetilide may increase the QTc-prolonging activities of Levofloxacin."
Clinical Note
moderateDofetilide + Norfloxacin
"Dofetilide may increase the QTc-prolonging activities of Norfloxacin."
Clinical Note
moderateDofetilide + Gemifloxacin
"Dofetilide may increase the QTc-prolonging activities of Gemifloxacin."
Clinical Note
moderateDofetilide + Torasemide
"Dofetilide may increase the QTc-prolonging activities of Torasemide."
Terminal half-life ranges 40–70 days (mean 55 days) due to extensive tissue accumulation, particularly in adipose tissue. Prolonged half-life necessitates loading doses and long washout periods.
Terminal elimination half-life: 10 hours (range 7–13 hours) in patients with normal renal function; prolonged in renal impairment, up to 20 hours in moderate impairment and >30 hours in severe impairment.
Primarily hepatic metabolism with biliary excretion; minimal renal elimination (<1% unchanged). Fecal excretion accounts for ~70% of the dose. Less than 10% excreted in urine.
Renal: 80% unchanged; biliary/fecal: 20% as metabolites and unchanged drug.
Category C
Category C
Antiarrhythmic (Class III)
Antiarrhythmic (Class III)