For conversion of atrial flutter, ibutilide or
dofetilide are recommended.
Dofetilide sales were impacted significantly by the launch of a number of new competitors with sales down by more than 80% to US$13m driven by pricing pressure, market share loss and shelf stock adjustments.
Currently, Sigmapharm's product line consists of Adefovir Dipivoxil Tablets, for hepatitis B, which is the first and only generic product equivalent to Hepsera tablets; Sodium Phenylbutyrate Powder, for urea cycle disorders, which is equivalent to Buphenyl powder; Acitretin Capsules, equivalent to Soriatane capsules with a primary indication for the treatment of severe psoriasis;
Dofetilide Capsules, equivalent to Tikosyn capsules for the treatment of arrhythmia; and Liothyronine Sodium Tablets, equivalent to Cytomel tablets for the treatment of hypothyroidism, which is now only available in 90-count (typical unit of use) bottles and is the most stable Liothyronine product on the market, with a recently Food and Drug Administration-approved shelf life of five years.
Historically, maintaining sinus rhythm has meant prescribing antiarrhythmic medications, such as amiodarone (Cordarone[R], Pacerone[R]),
dofetilide (Tikosyn[R]), dronedarone (Multaq[R]), flecainide (Tambocor[R]), propafenone (Rhythmol[R]), and Sotalol (Betapace[R]).
Pfizer medicines sunitinib, axitinib and
dofetilide are among those prescribed to treat these conditions.
It is notable that methadone is the second most frequent cause of drug arrhythmia after
dofetilide (Kao et al., 2013), according to the adverse event reporting system of the Food and Drug Administration (FDA).
Non-invasive strategies in management of high DFT includes: measuring the impedance and confirming all the connections; changing of polarity--changing the RV coil from anode (as usual) to a cathodal RV coil with a possible reduction of 10-15% in DFT; biphasic waveform tilt optimization, where manufacturers allow this option [16]; medication, Sotalol and
Dofetilide, are reported to reduce DFT [17, 18].
The use of these drugs (such as propafenone,
dofetilide, and amiodarone) has been limited by proarrhythmic and noncardiovascular toxicities as well as modest antiarrhythmic efficacy.
Similarly, many (66%) were on an antiarrhythmic medication at the time of evaluation for the ablation procedure (although all antiarrhythmic medication was held prior to the procedure), which included flecainide (32.4%), sotalol (19.4%), amiodarone (16.7%), dronedarone (13.0%), propafenone (9.3%),
dofetilide (6.5%), and diltiazem (2.8%).