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Digitoxin elimination reduced during quinidine therapy

M Garty, P Sood, D E Rollins

Annals of Internal Medicine

|January 1, 1981

Summary

Quinidine significantly increases serum digitoxin levels and prolongs its half-life in healthy volunteers. This drug interaction appears to stem from reduced digitoxin elimination, not altered tissue binding.

Area of Science:

Pharmacology
Clinical Toxicology

Background:

Quinidine is known to elevate serum digoxin concentrations, potentially causing toxicity.
The interaction between quinidine and other cardiac glycosides requires further investigation.

Purpose of the Study:

To determine if quinidine interacts with digitoxin, another cardiac glycoside.
To elucidate the pharmacokinetic basis of any observed quinidine-digitoxin interaction.

Main Methods:

A pharmacokinetic study was conducted in five healthy volunteers.
Serum digitoxin concentrations were measured in the presence and absence of quinidine.

Main Results:

Quinidine significantly increased mean digitoxin elimination half-life (87.8 to 218.3 h).

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Quinidine reduced mean total body clearance of digitoxin (5.01 to 1.87 mL/h x kg).

No significant changes in digitoxin volume of distribution were observed.

Conclusions:

Quinidine significantly alters digitoxin pharmacokinetics in healthy volunteers.
The primary mechanism of this interaction is a reduction in digitoxin elimination.
This suggests a potential for increased digitoxin toxicity when co-administered with quinidine.