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Related Experiment Videos

Digoxin and nifedipine.

J B Schwartz

    The American Journal of Cardiology
    |May 17, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Calcium-channel blockers like verapamil can significantly increase digoxin levels by affecting kidney clearance. However, nifedipine shows minimal impact on digoxin levels and no adverse effects, suggesting a safer combination.

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    Area of Science:

    • Pharmacology
    • Nephrology
    • Cardiology

    Background:

    • Digoxin is a cardiac glycoside commonly prescribed for heart conditions.
    • Its elimination is primarily dependent on renal function, specifically glomerular filtration and tubular secretion.
    • Calcium-channel antagonists are frequently used alongside digoxin, necessitating an understanding of potential drug interactions.

    Purpose of the Study:

    • To investigate the pharmacokinetic and pharmacodynamic interactions between digoxin and calcium-channel antagonists, specifically verapamil and nifedipine.
    • To elucidate the mechanisms underlying altered digoxin clearance when co-administered with these agents.
    • To assess the clinical significance of these interactions on patient outcomes.

    Main Methods:

    • Review of existing studies examining digoxin levels and renal clearance in patients receiving concomitant verapamil or nifedipine.

    Related Experiment Videos

  • Analysis of changes in creatinine clearance to differentiate between glomerular filtration and tubular secretion alterations.
  • Evaluation of physiological endpoints, including electrophysiologic correlates, in studies of digoxin-nifedipine interaction.

    • Main Results:

    • Verapamil significantly decreases digoxin clearance, increasing serum digoxin levels by approximately 50%, likely due to altered renal tubular secretion.
    • Nifedipine administration has shown no significant changes in digoxin pharmacokinetics or creatinine clearance in multiple studies.
    • While some studies suggest a potential 24-45% increase in digoxin levels with nifedipine, no significant changes in physiological effects or adverse events were observed.

    Conclusions:

    • Verapamil poses a significant risk of increasing digoxin levels, primarily through reduced renal tubular secretion.
    • Nifedipine appears to have a minimal pharmacokinetic interaction with digoxin, with no evidence of clinically significant adverse effects.
    • Combined digoxin and nifedipine therapy is likely safe, despite potential minor increases in serum digoxin concentrations.