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Verapamil-induced changes in digoxin kinetics in cirrhosis
European Journal of Clinical Pharmacology
|January 1, 1987
Summary
Verapamil significantly increases digoxin levels in patients with liver cirrhosis, affecting drug clearance. Healthy individuals experience minimal changes, highlighting cirrhosis as a key factor in this drug interaction.
Area of Science:
- Pharmacology
- Hepatology
- Clinical Medicine
Background:
- Digoxin is a crucial medication for heart conditions.
- Verapamil is a common cardiovascular drug.
- Drug interactions can alter medication efficacy and safety.
Purpose of the Study:
- To investigate the effect of verapamil on digoxin serum levels.
- To compare these effects in patients with hepatic cirrhosis versus healthy controls.
Main Methods:
- A single low dose of verapamil (80 mg) was administered.
- Digoxin serum levels (0.5 mg dose) were monitored.
- Study involved 6 cirrhotic patients and 6 healthy volunteers.
Main Results:
- Verapamil increased peak digoxin serum levels by 98% and AUC by 32% in cirrhotic patients.
- Renal digoxin clearance decreased by 23% in those with cirrhosis.
- Healthy subjects showed only minor changes in digoxin kinetics.
Conclusions:
- Hepatic cirrhosis significantly magnifies the impact of verapamil on digoxin pharmacokinetics.
- This interaction necessitates careful consideration in patients with liver disease.
- Reduced renal clearance is a key mechanism in this altered drug interaction.