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Spironolactone-induced changes in digoxin kinetics.

S Waldorff, J D Andersen, N Heebøll-Nielsen

    Clinical Pharmacology and Therapeutics
    |August 1, 1978
    PubMed
    Summary
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    Spironolactone treatment increases digoxin plasma concentrations by reducing its clearance. Dosing adjustments for digoxin are recommended during spironolactone therapy to prevent toxicity.

    Area of Science:

    • Pharmacokinetics
    • Clinical Pharmacology
    • Cardiovascular Drug Interactions

    Background:

    • Digoxin is a crucial medication for heart failure and arrhythmias.
    • Spironolactone is a potassium-sparing diuretic often used with digoxin.

    Purpose of the Study:

    • To investigate the pharmacokinetic interaction between digoxin and spironolactone.
    • To determine the effect of spironolactone on digoxin clearance and distribution.

    Main Methods:

    • Intravenous digoxin administration in 8 subjects.
    • Plasma concentrations and urinary excretion of digoxin measured.
    • Study repeated during long-term spironolactone treatment.

    Main Results:

    • Spironolactone significantly increased plasma digoxin concentrations.

    Related Experiment Videos

  • Plasma and renal clearances of digoxin were significantly decreased.
  • Volumes of distribution for digoxin were also significantly reduced.

    • Conclusions:

    • Spironolactone impairs digoxin elimination, likely via reduced tubular secretion.
    • Digoxin dosage (loading and maintenance) should be reduced when co-administered with spironolactone.
    • Further research is needed to assess potential changes in myocardial sensitivity.