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Related Experiment Videos

Interaction between digoxin and indomethacin or ibuprofen.

H S Jørgensen1, H R Christensen, J P Kampmann

  • 1Medical Department P, Bispebjerg Hospital, Copenhagen, Denmark.

British Journal of Clinical Pharmacology
|January 1, 1991
PubMed
Summary

Indomethacin, a non-steroidal anti-inflammatory drug, significantly increased serum digoxin levels in patients. Ibuprofen did not affect digoxin concentrations, highlighting potential drug interactions.

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Area of Science:

  • Pharmacology
  • Clinical Pharmacy
  • Drug Interactions

Background:

  • Digoxin is a cardiac glycoside used for heart failure and arrhythmias.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used for pain and inflammation.
  • Potential interactions between digoxin and NSAIDs require investigation.

Purpose of the Study:

  • To investigate the interaction between digoxin and two NSAIDs: indomethacin and ibuprofen.
  • To determine the effect of these NSAIDs on steady-state serum digoxin concentrations.

Main Methods:

  • 10 patients on chronic digoxin treatment received indomethacin (50 mg TID) for 10 days.
  • 8 patients on chronic digoxin treatment received ibuprofen (600 mg TID) for 10 days.
  • Serum digoxin levels were measured using fluorescence polarization immunoassay.

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Main Results:

  • Serum digoxin levels significantly increased (P < 0.05) during indomethacin treatment (0.73 ± 0.34 to 1.02 ± 0.43 nmol/L).
  • Ibuprofen administration did not alter steady-state serum digoxin concentrations.
  • Indomethacin increased digoxin levels into the higher therapeutic range.

Conclusions:

  • Indomethacin can increase serum digoxin concentrations, potentially leading to toxicity.
  • Clinicians should consider this interaction when co-administering indomethacin with digoxin.
  • Caution is advised when combining digoxin with NSAIDs that may affect its serum levels.