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Related Experiment Videos

The digoxin-amiodarone interaction.

K Robinson1, A Johnston, S Walker

  • 1Cardiovascular Unit, Hammersmith Hospital, London, UK.

Cardiovascular Drugs and Therapy
|March 1, 1989
PubMed
Summary
This summary is machine-generated.

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The concurrent use of amiodarone significantly increases plasma digoxin concentrations, an effect sustained for months. This digoxin-amiodarone interaction does not appear to stem from altered renal excretion of digoxin.

Area of Science:

  • Pharmacology
  • Clinical Pharmacy
  • Cardiology

Background:

  • Digoxin is a cardiac glycoside used for heart failure and arrhythmias.
  • Amiodarone is an antiarrhythmic drug with a complex pharmacology.
  • A known drug interaction exists between digoxin and amiodarone, leading to increased digoxin levels.

Purpose of the Study:

  • To investigate the cause of the digoxin-amiodarone interaction.
  • To assess the impact of amiodarone on digoxin's systemic availability and renal excretion.
  • To determine the duration of this drug interaction.

Main Methods:

  • Ten patients receiving digoxin were studied.
  • Digoxin pharmacokinetics were assessed before and after 1 week, 6 weeks, and 4-8 months of amiodarone therapy.

Related Experiment Videos

  • Plasma digoxin concentrations, area under the curve (AUC), and urinary digoxin clearance were measured.

    • Main Results:

    • Concurrent amiodarone therapy significantly increased mean peak plasma digoxin concentration (1.55 to 2.85 µg/L) and AUC (7.2 to 12.1 µg/L·h) after 1 week (p < 0.01).
    • These elevated digoxin levels persisted for at least 4-8 months.
    • Mean urinary digoxin clearance remained unchanged throughout the study.

    Conclusions:

    • The addition of amiodarone leads to a sustained increase in plasma digoxin concentrations.
    • The interaction is prolonged, lasting for several months.
    • The mechanism does not appear to involve alterations in the renal clearance of digoxin.