Dofetilide in Overdose: A Case Series from Poison Center Data
M A Hieger1,2,3, K F Maskell4,5,6, M J Moss6
1Division of Clinical Toxicology, Department of Emergency Medicine, VCU Medical Center, 1250 E. Marshall Street, 2nd Floor, Richmond, VA, 23298, USA. michellehieger@gmail.com.
Cardiovascular Toxicology
|August 28, 2016
Summary
Small dofetilide overdoses often cause no significant effects and can be managed at home. Large intentional overdoses, however, may lead to serious cardiac events requiring medical intervention.
Area of Science:
- Cardiology
- Clinical Toxicology
Background:
- Dofetilide is a Class III antiarrhythmic medication for atrial dysrhythmias.
- Adverse effects of dofetilide are known, but its toxicity in overdose is not well-documented.
Purpose of the Study:
- To describe the clinical effects and management of dofetilide overdose.
Main Methods:
- Retrospective case series of patients reported to a poison center for dofetilide overdose.
- Included 27 cases with varying overdose amounts and co-ingestants.
Main Results:
- Most patients (21/27) took only one extra capsule and experienced no significant clinical effects.
- One patient with a large intentional overdose (90x usual dose) developed non-sustained ventricular tachycardia and PVCs.
- No patients required cardioversion, defibrillation, CPR, or overdrive pacing.
Conclusions:
- Unintentional, small dofetilide overdoses may not cause significant clinical toxicity and can often be managed outside a healthcare facility.
- Large intentional overdoses pose a risk for significant cardiac events.
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