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CARDIOVASCULAR SYSTEM › CARDIAC THERAPY › ANTIARRHYTHMICS, CLASS I AND III › Antiarrhythmics, class III
tedisamil
C01BD06
Forms & Strengths
- Intravenous solution: 0.5 mg/mL, 1 mg/mL
- Oral capsules (investigational): 50 mg, 100 mg, 200 mg
Adult Dosing
- Atrial fibrillation/flutter conversion: IV infusion of 0.4 mg/kg to 0.8 mg/kg over 10-30 minutes
- Investigational oral dosing: 100 mg to 200 mg orally twice daily
Pediatric Dosing
- Safety and efficacy not established in pediatric patients
- No standard pediatric dosing recommendations available
Indications
- Rapid conversion of recent-onset atrial fibrillation to normal sinus rhythm
- Maintenance of sinus rhythm in patients with atrial arrhythmias (investigational)
Mechanism of Action
- Class III antiarrhythmic agent
- Potent blocker of multiple cardiac potassium channels, primarily transient outward (Ito) and ultrarapid delayed rectifier (IKur) K+ currents
- Prolonges cardiac action potential duration and refractory period in atrial and ventricular tissue
Contraindications
- Known hypersensitivity to tedisamil
- Pre-existing prolonged QT interval (baseline QTc > 450 ms)
- Significant structural heart disease, heart failure (NYHA Class III-IV), or acute myocardial infarction
- Concomitant use of other drugs that prolong the QT interval or cause Torsades de Pointes
- Severe bradycardia or second/third-degree AV block without a functioning pacemaker
Adverse Reactions
- Torsades de Pointes and severe ventricular arrhythmias
- QTc interval prolongation
- Bradycardia and hypotension
- Dizziness, headache, and nausea
- Injection site reactions (for intravenous administration)
Drug Interactions
- Class IA and Class III antiarrhythmic drugs (additive risk of excessive QT prolongation and arrhythmias)
- CYP3A4 inhibitors (may increase systemic exposure of tedisamil)
- Drugs that induce hypokalemia or hypomagnesemia (increased risk of ventricular arrhythmias)
- Negative chronotropes such as beta-blockers and non-dihydropyridine calcium channel blockers (increased risk of severe bradycardia)
Curated Content: Needs Vetting Before Put to Clinical Use