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[Quinidine-digoxin interaction (author's transl)]

W Doering, M Höhne, J Wagner

    Deutsche Medizinische Wochenschrift (1946)
    |October 16, 1981
    PubMed
    Summary
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    Quinidine significantly increases serum digoxin levels and prolongs its half-life, especially in patients on chronic quinidine-digoxin medication. Monitor digoxin levels carefully after discontinuing quinidine.

    Area of Science:

    • Pharmacology
    • Drug Interactions
    • Clinical Pharmacy

    Context:

    • Quinidine and digoxin are commonly prescribed medications.
    • Understanding their interaction is crucial for patient safety.
    • Previous studies have indicated potential interactions, but the precise mechanisms and clinical significance require further elucidation.

    Purpose:

    • To investigate the impact of quinidine on digoxin pharmacokinetics.
    • To determine the effects of quinidine on digoxin serum concentration and elimination half-life.
    • To provide guidance on therapeutic drug monitoring for patients on combined quinidine-digoxin therapy.

    Summary:

    • An additional 500 mg dose of quinidine increased serum digoxin concentration by up to 46% and prolonged digoxin's half-life from 50 to 100 hours in patients on chronic quinidine-digoxin medication.

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  • These pharmacokinetic changes were less pronounced in individuals treated only with digoxin.
  • Quinidine was found to both reduce digoxin elimination and induce transient digoxin redistribution, leading to sustained increases in serum digoxin levels.

    • Impact:

    • Highlights the significant pharmacokinetic interaction between quinidine and digoxin.
    • Suggests that serum digoxin levels should be measured at least 8 hours after the last dose of both medications.
    • Emphasizes the need to consider prolonged digoxin elimination when discontinuing digoxin, particularly if quinidine therapy continues, such as before electric cardioversion.