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Pharmacokinetic interactions with digoxin.

S M Rodin1, B F Johnson

  • 1Division of Clinical Pharmacology, University of Massachusetts Medical Center, Worcester.

Clinical Pharmacokinetics
|October 1, 1988
PubMed
Summary
This summary is machine-generated.

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Digoxin drug interactions are common, affecting absorption and bioavailability. Capsule formulations may reduce some interactions, but careful analysis is needed for cardiac patients on digoxin.

Area of Science:

  • Pharmacology
  • Clinical Pharmacy

Background:

  • Digoxin is a critical medication for cardiac patients.
  • Numerous drugs can interact with digoxin, altering its efficacy and safety.
  • Understanding these interactions is vital for patient care.

Purpose of the Study:

  • To review and synthesize information on pharmacokinetic interactions with digoxin.
  • To identify drugs that affect digoxin absorption, distribution, and clearance.
  • To highlight interactions relevant to cardiac patients.

Main Methods:

  • Literature review of pharmacological agents and their interactions with digoxin.
  • Analysis of studies reporting effects on digoxin absorption, bioavailability, volume of distribution, and clearance.
  • Identification of specific drug classes and individual agents involved in interactions.

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Main Results:

  • Several drugs, including antacids, antidiarrheals, cholestyramine, and certain antibiotics, reduce digoxin absorption.
  • Some antibiotics (erythromycin, tetracycline) can increase digoxin bioavailability.
  • Cardiac medications like quinidine, amiodarone, verapamil, and nifedipine frequently interact with digoxin.
  • Capsule formulations of digoxin may exhibit different interaction profiles compared to tablets.
  • Discrepant study results necessitate careful evaluation of research methodologies.

Conclusions:

  • Clinically significant pharmacokinetic interactions with digoxin are prevalent.
  • Drug interactions can alter digoxin absorption, bioavailability, and elimination.
  • Cardiac patients on digoxin require vigilant monitoring for drug interactions.
  • Formulation differences (capsule vs. tablet) can influence interactions.
  • Critical appraisal of study designs is essential for accurate clinical interpretation.