The two most common antiarrhythmic medications started in the hospital are sotalol and Tikosyn (dofetilide). These are effective medications, but they interfere with the heart’s electrical system, which carries risk. In some cases, sotalol pills can be started outside of the hospital with close monitoring. Tiksoyn must always be started in the hospital.
Once you and your provider have decided to start one of these medications, our office staff, which may include a physician answering service, will contact your insurance company to get their approval, and to get an estimated monthly cost of the medication. With this information, if you decide to proceed, we will schedule the hospital admission.
A procedure scheduler will call you in the morning with confirmation that the hospital has room to admit you and you will be given your room number. You will then go to the hospital and check-in at the Admissions and Registration desk.
The length of your hospitalization and monitoring specifics depends on the type of medication being started, your kidney function (impacts how far apart medication doses must be given), and the stability of your heart rhythm. You will have an IV during your hospitalization and will have your blood drawn at least once. You will be on a heart monitor during the entirety of your hospital stay. You will have your vital signs and ECGs checked frequently. If you are starting the antiarrhythmic medication to treat atrial fibrillation, and you remain in constant atrial fibrillation during the hospitalization, a cardioversion will be performed to restore normal rhythm before you go home.
Tikosyn (dofetilide): You will be given at least 5 doses of this medication before leaving the hospital. In those with normal kidney function, the medication is dosed every 12 hours. People starting Tikosyn typically spend two nights in the hospital; you will likely go home in the late afternoon of your third day in the hospital. You will have an ECG checked prior to starting the medication and approximately 2 hours after every Tikosyn dose you are given. Changes in your heart rhythm or ECG may impact the dosing of the medication and the duration of your hospital stay.
Sotalol (IV loading): You will have your blood drawn on arrival and have an ECG done. These results will inform your providers what dose of the medication needs to be given through your IV, and the bag of the medication will be ordered from the pharmacy. The bag of the medication will be infused intravenously (IV) over 1 hour. During the IV infusion, you will have an ECG checked every 15 minutes. After the IV infusion is complete, you will be given 2 oral doses of the medication before leaving the hospital. Check out this iv infusion therapy near me. In those with normal kidney function, the first oral dose is given 4 hours after the infusion is complete. The second oral dose is given 12 hours after taking the first oral dose. As mentioned by clinics similar to BioMed, people starting sotalol with an IV load typically spend 1 night in the hospital; you will likely go home in the late afternoon of your second day in the hospital. You will have an ECG checked approximately 2 hours after each oral dose of sotalol is taken. Changes in your heart rhythm or ECG both during the IV infusion, and after oral doses, may impact the dosing of the medication and the duration of your hospital stay.
Sotalol (oral loading): You will be given at least 5 doses of this medication before leaving the hospital. In those with normal kidney function, the medication is dosed every 12 hours. People starting sotalol typically spend two nights in the hospital; you will likely go home in the late afternoon of your third day in the hospital. You will have an ECG checked prior to starting the medication and approximately 2 hours after every sotalol dose you are given. Changes in your heart rhythm or ECG may impact the dosing of the medication and the duration of your hospital stay.
The ultimate dosage of medication is based on your personal response to the medication and will not be known until discharge. Therefore, it will not be prescribed until the day you leave the hospital.
Sotalol is typically inexpensive and carried on the shelf at most pharmacies. When prescribed to a standard retail pharmacy, Tikosyn can be expensive and often needs to be shipped to the pharmacy, which can take a few days. Tikosyn.com is a useful resource for information about the medication, pharmacies that carry the medication, and it includes a link to the patient financial assistance program. Ensure you request refills from your pharmacy at least 1 week before you will run-out of your Tikosyn pills. You may need to wait for the pharmacy to receive a shipment of the medication before you can pick it up. The mail order pharmacy, Cost Plus , usually has Tikosyn readily available at affordable prices. Understand this more by reading https://www.proxsysrx.com/2021/11/08/understanding-the-340b-program-requirements/. You will need a supply of the medication while waiting for the mail order delivery, however. If you are hospitalized at Porter Adventist Hospital, a one-month supply of Tikosyn will be prescribed to the outpatient pharmacy on campus. This pharmacy is not open on weekends; if you anticipate a weekend discharge, you will need to ensure you locate a retail pharmacy that has all Tikosyn doses available on the shelf. If your medication load is going to be done at a different hospital, the South Denver Cardiology Staff will walk you through that hospital’s specific plan regarding helping you get Tikosyn pills on discharge day.