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Related Experiment Videos

Digoxin-quinidine-spironolactone interaction.

P E Fenster, W D Hager, M M Goodman

    Clinical Pharmacology and Therapeutics
    |July 1, 1984
    PubMed
    Summary
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    Quinidine and spironolactone significantly alter digoxin pharmacokinetics, reducing its clearance and prolonging its half-life. Combining these drugs causes a greater effect on digoxin, necessitating dose adjustments.

    Area of Science:

    • Pharmacology
    • Drug Interactions
    • Clinical Pharmacokinetics

    Background:

    • Digoxin is a cardiac glycoside with a narrow therapeutic index.
    • Quinidine and spironolactone are known to affect digoxin pharmacokinetics individually.
    • The combined effect of quinidine and spironolactone on digoxin kinetics requires further investigation.

    Purpose of the Study:

    • To evaluate the impact of quinidine and spironolactone, alone and in combination, on digoxin pharmacokinetics.
    • To compare the effects of each drug and their combination on digoxin clearance and elimination half-life.

    Main Methods:

    • Six healthy subjects received a 1.0-mg intravenous dose of digoxin.
    • Digoxin was administered alone, with quinidine, with spironolactone, and with both agents.

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  • Systemic, renal, and nonrenal clearances, as well as elimination half-life, were assessed.

    • Main Results:

    • Both quinidine and spironolactone reduced digoxin systemic, renal, and nonrenal clearances.
    • Both drugs prolonged the digoxin elimination half-life.
    • The combination of quinidine and spironolactone resulted in a more pronounced alteration of digoxin kinetics than either drug alone.

    Conclusions:

    • Concomitant use of quinidine and spironolactone significantly alters digoxin pharmacokinetics.
    • A reduction in digoxin dosage, careful clinical monitoring, and serum concentration measurements are recommended when using these drug combinations.