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Related Experiment Videos

Digoxin-quinidine interaction Pharmacokinetic evaluation.

W D Hager, P Fenster, M Mayersohn

    The New England Journal of Medicine
    |May 31, 1979
    PubMed
    Summary
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    Quinidine significantly alters digoxin pharmacokinetics, reducing its clearance and volume of distribution. This drug interaction may lead to higher digoxin plasma concentrations, necessitating careful patient monitoring.

    Area of Science:

    • Pharmacology
    • Clinical Pharmacy
    • Drug Interactions

    Background:

    • Digoxin is a cardiac glycoside used to treat heart failure and arrhythmias.
    • Recent reports indicate increased digoxin plasma concentrations when co-administered with quinidine.

    Purpose of the Study:

    • To investigate the pharmacokinetic changes of digoxin during co-administration with quinidine.
    • To elucidate the mechanisms behind the digoxin-quinidine interaction.

    Main Methods:

    • A pharmacokinetic study involving six subjects.
    • Measurement of digoxin elimination half-life, total body clearance, renal clearance, and volume of distribution with and without quinidine.

    Main Results:

    • Digoxin elimination half-life remained largely unchanged (42 vs. 44 hours).

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  • Total body clearance decreased from 3.08 to 1.96 ml/min/kg.
  • Renal clearance decreased from 1.64 to 1.09 ml/min/kg.
  • Volume of distribution decreased from 10.87 to 7.35 L/kg.

    • Conclusions:

    • Quinidine significantly reduces digoxin's total body and renal clearance, and its volume of distribution.
    • The observed increase in digoxin plasma concentrations is likely due to tissue binding displacement and potential inhibition of renal secretion by quinidine.