Drug & supplement interaction

Ephedra + Dofetilide

Dofetilide brand name: Tikosyn.

Major Interaction
Medically reviewed by · Updated October 2026
The bottom line Major

Ephedra has a major interaction with Dofetilide. Theoretically, ephedra might have an additive effect with drugs that prolong the QT interval.

Read the full interaction report
SeverityMajor
LikelihoodProbable
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ephedra and Dofetilide

Here is the interaction we found between these two, with the evidence behind it.

Major

QT INTERVAL-PROLONGING DRUGS

Why this applies to Dofetilide

Dofetilide falls under QT INTERVAL-PROLONGING DRUGS — the group Ephedra interacts with.

Theoretically, ephedra might have an additive effect with drugs that prolong the QT interval.
Even in healthy volunteers, EKG changes including prolonged QT interval and premature atrial contractions have been reported with ingestion of recommended doses of ephedra. Ephedra may have an additive effect with drugs that prolong the QT interval. This may increase the risk of ventricular arrhythmias.
Severity Major Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with these two together. Dofetilide (Tikosyn) works by deliberately slowing part of your heart's electrical reset, which stretches out the QT interval on an EKG. That's how it controls your rhythm, but it also means there's very little wiggle room before that stretch becomes dangerous. Dofetilide is one of the most QT-sensitive drugs we have, which is why it's started in the hospital with careful monitoring.

Ephedra is a stimulant that can speed up the heart and, on its own, has been shown to lengthen the QT and trigger extra beats even at normal doses. Stacking that on top of dofetilide can add together and raise the risk of a serious arrhythmia like torsades. The evidence here isn't ironclad, but given the stakes I'd treat it as a real risk. Please don't use ephedra (it's banned in U.S. supplements anyway) and talk with your doctor or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Jenkins DJ, Wesson V, Wolever TM, et al. Wholemeal versus wholegrain breads: proportion of whole or cracked grain and the glycaemic response. BMJ 1988;297:958-60. PubMed
  2. McBride BF, Karapanos AK, Krudysz A, et al. Electrocardiographic and hemodynamic effects of a multicomponent dietary supplement containing ephedra and caffeine: a randomized controlled trial. JAMA 2004;291:216-21. PubMed
  3. Gardner SF, Franks AM, Gurley BJ, et al. Effect of a multicomponent, ephedra-containing dietary supplement (Metabolife 356) on Holter monitoring and hemostatic parameters in healthy volunteers. Am J Cardiol 2003;91:1510-3, A9. PubMed
  4. Gardner, S. F., Franks, A. M., Gurley, B. J., Haller, C. A., Singh, B. K., and Mehta, J. L. Effect of a multicomponent, ephedra-containing dietary supplement (Metabolife 356) on Holter monitoring and hemostatic parameters in healthy volunteers. Am J Card PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Ephedra Also Interacts With Other Medications

Ephedra has 336 major, 497 moderate known drug interactions in our database — the Dofetilide one above is one of them. If you take anything else, check it against the full list below.

Major 336 Moderate 497 No known interaction 1,997 (incl. Dofetilide)
Taking anything else?

Check Another of Your Medications Against Ephedra

Covers the 2,830 medications we’ve checked against Ephedra. Pick one to open its full report.

From our Q&A

Questions About Ephedra or Dofetilide

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Ephedra or Dofetilide, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Dofetilide

This page covers Ephedra only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Dofetilide page lists 146 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Grapefruit (major).

By severity: 8 major · 98 moderate · 40 minor.

From our pharmacist’s overview on the Dofetilide page

“Dofetilide (Tikosyn) controls abnormal heart rhythms, and it is dosed so precisely that most people start it in the hospital under ECG monitoring. Supplements deserve matching care.”

Reviewed by 2 · Jul 18, 2026

Open the Dofetilide interaction page

One more smart check

Taking Ephedra as Part of a Dietary Supplement Product? Check It for Interactions

We hold 37 real supplement products containing Ephedra, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ephedra. Your product may carry other ingredients that interact with Dofetilide too, on top of Ephedra — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Ephedra and Dofetilide Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Ephedra
Top half

#600 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Dofetilide
Top half

#781 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Ephedra

What is Ephedra?

Ephedra
  • Weight loss
  • Nasal and sinus congestion
  • Asthma and breathing problems
  • Boosting energy and athletic performance
  • Allergies

Ephedra (ma huang) contains powerful stimulants like ephedrine that affect the heart and nervous system. Because it has been linked to serious harms including high blood pressure, stroke, and death, it is banned for use in dietary supplements in the U.S. and many other countries. We do not recommend using ephedra-containing supplements; talk to your pharmacist or doctor about safer, approved options.

Read the full Ephedra monograph & all interactions
Medication

About Dofetilide

What Is Dofetilide Used For?

Brand name: Tikosyn

Dofetilide capsules are used in two main ways for people with atrial fibrillation (AF) or atrial flutter (AFl) — abnormal, often rapid heart rhythms. First, they can help convert these abnormal rhythms back to a normal heart rhythm. Second, once a normal rhythm has been restored, dofetilide can help maintain it and delay the time before the abnormal rhythm comes back.

Because dofetilide can cause dangerous heart rhythm problems of its own, it is reserved for patients whose atrial fibrillation or atrial flutter causes significant symptoms. It has not been shown to be effective for paroxysmal atrial fibrillation (short, self-terminating episodes). The brand Tikosyn carries the same two approved uses.

See full Dofetilide drug information
Keep checking

Other Drugs & Ephedra

Browse every other medication we’ve checked against Ephedra — both the ones with a known interaction and the ones without. Select any drug for the full detail.

336Major
497Moderate
0Minor
1,996No known interaction
336 Major 497 Moderate 1,996 No interaction
Major

336 interactions

Showing 60 of 336 major interactions — see all 336 on the Ephedra page.

Moderate

497 interactions

Showing 60 of 497 moderate interactions — see all 497 on the Ephedra page.

No interaction 1,996 drugs checked — show the list

We also checked Ephedra against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,996 medications checked with no known interaction — see the full Ephedra list.

See the full Ephedra interactions page
See every supplement checked against Dofetilide, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Ephedra monograph › Uses, safety, and every drug interaction in one place Dofetilide supplement interactions › Every supplement checked against Dofetilide, ranked by severity Dofetilide drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Ephedra and Dofetilide Together: Common Questions

Can you take Ephedra with Dofetilide?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Ephedra and Dofetilide interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Dofetilide and Ephedra?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.