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mnmnmnmn · 11-12-2006, 05:22 PM

So after failing many antiarrrhythmics I am again looking at switching drugs due to poor heart rate control. I just spent a few days in the hospital to have some minor surgery, and my cardiologist and I discussed Tikosyn. I had never heard of the drug until then, however since I was on the heart floor for recovery, the only thing I learned about it is a bit jaded (a lady two rooms down from me coded twice in one day and was shocked due to Vtach from induction of tikosyn). This none the least scared the you know what out of me. Yes I am young and have only mild valve regurg, but still the thought of other arrhythmias and not to mention shocking, scares me. I want to know how safe this drug is?? Is it effective?? I have a hard time finding success rates of drugs on the internet, not to mention percent of side affects. Anyone know about this drug, experienced anything with this drug, or worked with this drug????? Remember I have mostly atrial tachycardia, but also SVT and sinus tach.

Lenin · 11-13-2006, 09:59 AM

mnmnmnmn,

You had me searching..

Anyhoo, Tikosyn) dofetelide is in the same class of antiarrythmics as sotalol...Vaugn Williams Class 3 (gee, the singer or the composer

) via Potassium channel blockade and prolonged repolarization.

Others in this class are Ibutilide, amiodarone, and bretylium.
The Vaugn Williams classification is by effect only and thus drugs are not necessarily similar, only the effects. People might do far better on one or the other.

Now I know why sotalol is uniquely effective among the beta-blockers for A-fib.

Here's a nice categorization of the various classes of antiarrhythmics from the University of Utah:

Class I
Sodium Channel Blockade

** Class IA
Prolong repolarization
Quinidine, procainamide, disopyramide

**Class IB
Shorten repolarization
Lidocaine, mexiletine, tocainide, phenytoin

**Class IC
Little effect on repolarization
Encainide, flecainide, propafenone, moricizine(?)

Class II
Beta-Adrenergic Blockade Propanolol, esmolol, acebutolol, l-sotalol

Class III
Prolong Repolarization (Potassium Channel Blockade; Other )
Ibutilide, dofetilide, sotalol (d,l), amiodarone, bretylium

Class IV
Calcium Channel Blockade
Verapamil, diltiazem, bepridil

Class: Miscellaneous
Miscellaneous Actions
Adenosine, digitalis, magnesium

mnmnmnmn · 11-14-2006, 10:47 AM

Lenin... well at least I made you think.. and well work too!!! I have become all too familiar with the classes of antiarrhythmic drugs, unfortunately. And thanks for the info. I really would like to hear from someone that has tried this drug, but I dont know that I am going to find them. I think Tikosyn is a pretty rarely used drug as I know that it has a very strict regimen for dosing and prescribing. Guess I might have to just take the advice of my cardiologist and trust him. One thing about Sotalol, sotalol produces affects more of an antiarrhythmic, like flecainide, but has a small beta blocker affect. That is why it isnt used a whole lot compared to the beta blockers like metoprolol, atenolol, etc. Although for me I have had a pretty significant beta blocker affect in that it has lowered my blood pressure a fair amount, yet hasnt worked with my tachycardia. I was told that Sotalol is a very hit or miss drug, either you have good results or no results at all, which again is why it isnt one that is tried right away for SVT or tachycardias, and with better drugs out there for afib, it isnt a first line drug for that either. However it is a good combo drug since it exhibits both properties. I am very curious about tikosyn and its effectiveness. You wanna try it first for me and let me know????

Lenin · 11-15-2006, 05:37 AM

I read that the entire Vaugn Williams class 3 are very different from one another and affect some people vastly different from others. I guess you just have to work your way through them by trial and error.

I agree, you probably won't find anyone who has taken Tikosyn. You'll have to write the book on the subject!

Lenin · 11-15-2006, 05:39 AM

I read that the entire Vaugn Williams class 3 are very different from one another and affect some people vastly different from others. I guess you just have to work your way through them by trial and error.

I agree, you probably won't find anyone who has taken Tikosyn. You'll have to write the book on the subject!

Have you given any thought to digitalis?

careannm · 11-16-2006, 09:31 AM

I was on Tikosyn from July until I just went off of it in November. I did have to be hospitalized for 3 days while they got the dosage right. I have had a-fib and been dealing with that for the last 2 years. I've been on Sotalol, Flecanide, Tikosyn, etc. I have had 3 cardioversions and 1 ablation. The doctors want to now put me on Amiodorone and after reading the information sheet on it I am refusing to go on it. It looks like horrible side affects. At the moment I am on Toprol 100 mg 1x/day and 1 10mg Pepcid and 1 81mg of Baby Aspirin a day. I should be on another heart medication since I went off the Tikosyn but am waiting to discuss all this with my cardiologist tomorrow. Doctors want to do a 2nd ablation and I'm trying to avoid that. Tikosyn worked for awhile and I didn't have side affects but was monitored pretty carefully but then my heart just kept going back into a-fib so they need to do something else. Hope to find out more at my doctors appt. tomorrow. Thoughts on Amiodorone and side effects or long term effects? Long term effects look like lung & liver damage, increased heart rate, etc. Doesn't look good.

mnmnmnmn · 11-16-2006, 10:36 PM

careann... ty very much for your reply. You at least give me a little hope I guess. I am back in the hospital and talked with my cardiologist about Tikosyn again today and we decided to wait until things calm down with my other issues. The only thing that I have heard about Amio is that it has horrible long term affects on the lungs... particularly pulmonary fibrosis. I would think you might want to try the ablation before going to amio. Good luck with that.

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