Augmented Digoxin Concentrations with Carvedilol Dosing in Mild-Moderate Heart Failure

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John W. Grunden1, Edward M. Gilbert, Mark A. Munger

  • 1Departments of Medicine and Pharmacy Practice, University of Utah, Salt Lake City, UT 84112, USA.

American Journal of Therapeutics
|August 1, 1994
PubMed

Insights

Carvedilol, a beta-blocker, showed a slight increase in serum digoxin levels in heart failure patients. However, this did not necessitate dosage changes or cause adverse events in most cases.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Carvedilol is a beta-adrenergic blocking agent used for heart failure.
  • Previous studies suggest carvedilol improves left ventricular function.
  • The impact of carvedilol on serum digoxin levels in heart failure patients remains unclear.

Purpose of the Study:

  • To investigate the effect of carvedilol on serum digoxin concentrations in patients with heart failure.

Main Methods:

  • A prospective, double-blind, placebo-controlled trial was conducted.
  • 22 patients with idiopathic dilated cardiomyopathy (NYHA class II-III) were enrolled.
  • Patients were selected from a larger trial on carvedilol's efficacy in heart failure.

Main Results:

  • Carvedilol administration resulted in a 26% increase in steady-state serum digoxin concentrations compared to placebo (p = NS).
  • No patients required digoxin dosage adjustments.
  • No clinically significant adverse events related to increased digoxin levels were observed.

Conclusions:

  • Carvedilol does not cause clinically significant changes in serum digoxin concentrations in most heart failure patients.
  • Caution is advised when coadministering carvedilol with digoxin, especially in patients with already elevated digoxin levels.

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