CriticalClass III antiarrhythmic, selective IKr blocker×Systemic antimycotics. Imidazole derivatives
Updated · Methodology
Mechanism
Ketoconazole inhibits CYP3A4 (dofetilide metabolism) and OCT2. Dofetilide rises 4-fold. FDA Tikosyn Section 4.3.
Symptoms
Torsades de pointes.
Management
Combination contraindicated.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Tikosyn (dofetilide) prescribing information (2019)– FDA Tikosyn label, Section 4 Contraindications