Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
Therapeutic Drug Monitoring: Drug Analysis Methods01:26

Therapeutic Drug Monitoring: Drug Analysis Methods

Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood or body tissues to tailor drug therapy effectively. This monitoring is critical for managing drugs with narrow therapeutic indices like digoxin and phenytoin, ensuring they are both safe and effective. For instance, monitoring theophylline levels in asthma patients involves precision and sensitivity to adjust doses according to individual responses to therapy, ensuring efficacy and...
Drug Toxicity: Risk factors01:24

Drug Toxicity: Risk factors

Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Shear Bond Strength of Liner Materials to Caries-Free and Caries-Affected Dentin.

Operative dentistry·2025
Same author

Increased risk of haematological malignancy in adults over age 60 with thrombocytopenia compared with matched controls: Time for an upfront bone marrow evaluation?

British journal of haematology·2024
Same author

A dynamical measure of the black hole mass in a quasar 11 billion years ago.

Nature·2024
Same author

Impact of Extracellular DNA on Architectural Parameters of <i>Leptospira biflexa</i> Biofilm.

Indian journal of microbiology·2023
Same author

An integrated biological effects assessment of the discharge water into the Sunndalsfjord from an aluminium smelter.

The Science of the total environment·2023
Same author

Benign metastasizing leiomyoma presenting as multiple pulmonary nodules: A radiological-pathological correlation.

Pulmonology·2022
Same journal

Effects of Trimethoprim on Three Previously Proposed Putative Biomarkers for OCT2/MATE-Mediated Renal Drug-Drug Interactions in Healthy Volunteers.

Clinical pharmacology and therapeutics·2026
Same journal

Clinical Characterization of Enzyme and Transporter Precipitants to Evaluate Drug-Drug Interactions for Orforglipron, a Small Molecule Glucagon-Like Peptide-1 Receptor Agonist.

Clinical pharmacology and therapeutics·2026
Same journal

Symposium Report: Stakeholders' Perspectives on Phase 1 Trials in Japanese Prior to Multi-Regional Clinical Trials and Future Pathways.

Clinical pharmacology and therapeutics·2026
Same journal

Resolving CYP2D6 Structural Complexity with Long-Read Sequencing: Implications for Tamoxifen Precision Dosing in Thai Breast Cancer Patients.

Clinical pharmacology and therapeutics·2026
Same journal

Identification of a Functional CYP2C8 Variant Allele that Alters Splicing, Reduces Protein Expression, and Increases Drug Exposure.

Clinical pharmacology and therapeutics·2026
Same journal

Risk of Hyperkalemia in Patients with Heart Failure Treated with Spironolactone in Combination with Sacubitril/Valsartan vs. Renin-Angiotensin System Inhibitors.

Clinical pharmacology and therapeutics·2026
See all related articles

Related Experiment Video

Updated: Jun 21, 2026

High-Throughput Optical Controlling and Recording Calcium Signal in iPSC-Derived Cardiomyocytes for Toxicity Testing and Phenotypic Drug Screening
10:01

High-Throughput Optical Controlling and Recording Calcium Signal in iPSC-Derived Cardiomyocytes for Toxicity Testing and Phenotypic Drug Screening

Published on: March 31, 2022

Macrolide-induced digoxin toxicity: a population-based study.

T Gomes1, M M Mamdani, D N Juurlink

  • 1The Institute for Clinical Evaluative Sciences, Ontario, Canada.

Clinical Pharmacology and Therapeutics
|July 17, 2009
PubMed
Summary
This summary is machine-generated.

Clarithromycin use significantly increases the risk of digoxin toxicity hospitalization. Other macrolides like erythromycin and azithromycin pose a much lower risk, while cefuroxime showed no increased risk.

More Related Videos

High-Throughput Cardiotoxicity Screening Using Mature Human Induced Pluripotent Stem Cell-Derived Cardiomyocyte Monolayers
14:03

High-Throughput Cardiotoxicity Screening Using Mature Human Induced Pluripotent Stem Cell-Derived Cardiomyocyte Monolayers

Published on: March 24, 2023

Related Experiment Videos

Last Updated: Jun 21, 2026

High-Throughput Optical Controlling and Recording Calcium Signal in iPSC-Derived Cardiomyocytes for Toxicity Testing and Phenotypic Drug Screening
10:01

High-Throughput Optical Controlling and Recording Calcium Signal in iPSC-Derived Cardiomyocytes for Toxicity Testing and Phenotypic Drug Screening

Published on: March 31, 2022

High-Throughput Cardiotoxicity Screening Using Mature Human Induced Pluripotent Stem Cell-Derived Cardiomyocyte Monolayers
14:03

High-Throughput Cardiotoxicity Screening Using Mature Human Induced Pluripotent Stem Cell-Derived Cardiomyocyte Monolayers

Published on: March 24, 2023

Area of Science:

  • Pharmacology
  • Drug Interactions
  • Clinical Toxicology

Background:

  • Digoxin is a crucial medication for heart failure and arrhythmias.
  • Macrolide antibiotics are commonly prescribed, raising concerns about potential drug interactions.
  • Previous research has suggested potential interactions between digoxin and macrolides, but specific risks by agent are not well-defined.

Purpose of the Study:

  • To investigate the association between recent exposure to individual macrolide antibiotics and hospitalization for digoxin toxicity.
  • To quantify the risk of digoxin toxicity associated with clarithromycin, erythromycin, and azithromycin compared to a non-interacting antibiotic.

Main Methods:

  • A 15-year, population-based, nested case-control study design was employed.
  • Hospitalization for digoxin toxicity served as the outcome of interest.
  • Exposure to individual macrolide antibiotics (clarithromycin, erythromycin, azithromycin) and a comparator (cefuroxime) was assessed.

Main Results:

  • Clarithromycin exposure was strongly associated with a significantly increased risk of digoxin toxicity hospitalization (adjusted OR 14.8; 95% CI 7.9-27.9).
  • Erythromycin and azithromycin showed a substantially lower, yet still elevated, risk (adjusted OR 3.7; 95% CI 1.7-7.9 and adjusted OR 3.7; 95% CI 1.1-12.5, respectively).
  • No increased risk of digoxin toxicity was observed with cefuroxime exposure (adjusted OR 0.8; 95% CI 0.2-3.4).

Conclusions:

  • Clarithromycin poses a significant risk for precipitating digoxin toxicity, necessitating caution when co-prescribing.
  • While erythromycin and azithromycin also show some association, the risk appears considerably lower than with clarithromycin.
  • These findings highlight the importance of considering specific macrolide antibiotic agents when assessing the risk of drug interactions with digoxin.