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Digoxin bioavailability during quinidine administration

W D Hager, M Mayersohn, P E Graves

    Clinical Pharmacology and Therapeutics
    |November 1, 1981
    PubMed
    Summary
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    Quinidine does not change how the body absorbs digoxin, despite higher digoxin levels observed. This study found no alteration in digoxin bioavailability when taken with quinidine.

    Area of Science:

    • Pharmacology
    • Drug Interactions
    • Clinical Pharmacology

    Background:

    • Elevated digoxin serum concentrations are observed when co-administered with quinidine.
    • The mechanism behind this interaction, specifically potential alterations in digoxin bioavailability, requires investigation.

    Purpose of the Study:

    • To investigate whether quinidine administration affects the oral bioavailability of digoxin.
    • To determine if altered digoxin absorption contributes to increased serum concentrations in patients taking quinidine.

    Main Methods:

    • Six subjects received intravenous and oral digoxin (1.0 mg) on alternate weeks during steady-state oral quinidine therapy.
    • Digoxin bioavailability was assessed by comparing area under the concentration-time curve (AUC) and urinary excretion (Xxu) after oral versus intravenous administration.

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  • Serum concentrations of both digoxin and quinidine were monitored over 96 hours post-administration.

    • Main Results:

    • Digoxin bioavailability, assessed via serum AUC (73.5% vs. 79.5%) and urinary excretion (69.8% vs. 70.2%), showed no statistically significant difference between administration with and without quinidine (P > 0.05).
    • Steady-state quinidine serum concentrations remained unchanged during the 4 days following both intravenous and oral digoxin administration.
    • No significant alteration in digoxin absorption or elimination was detected due to concurrent quinidine use.

    Conclusions:

    • Quinidine does not alter the oral bioavailability of digoxin.
    • The observed increase in digoxin serum concentration in the presence of quinidine is not explained by changes in digoxin absorption.
    • Further research is needed to elucidate the mechanism behind the quinidine-induced rise in digoxin serum levels.