What are the interactions with digoxin?

What are the interactions with digoxin?

Digoxin has many interactions, including:

  • Erythromycin and tetracycline (antibiotics)
  • Antiarrhythmic drugs (amiodarone)
  • Calcium channel blockers.
  • Over-the-counter antacids.
  • Hawthorn (an herbal remedy)
  • Black licorice.
  • Large amounts of oatmeal, milk and high-fibre cereals.

What is digoxin pharmacokinetics?

Abstract. About 70 to 80% of an oral dose of digoxin is absorbed, mainly in the proximal part of the small intestine. The degree of binding to serum albumin is 20 to 30%. Digoxin is extensively distributed in the tissues, as reflected by the large volume of distribution.

What are pharmacokinetic interactions?

Pharmacokinetic drug-drug interactions occur when a drug alters the disposition (absorption, distribution, elimination) of a coadministered agent. Pharmacokinetic interactions may result in the increase or the decrease of plasma drug concentrations.

Which drug is contraindicated with digoxin?

Digoxin may present interactions with the following: Azole antifungals, which inhibit the transport of digoxin via human P-glycoprotein. Macrolide antibiotics, which inhibit P-glycoprotein, thus increasing intestinal drug absorption. Rifampin.

What antibiotics interfere with digoxin?

Certain antibiotics including sulphasalazine, neomycin and aminosalicylic acid reduce digoxin absorption while others, including erythromycin and tetracycline, increase the bioavailability of digoxin in some patients.

Is an example of pharmacokinetic drug interactions?

Pharmacokinetic interactions occur at the levels of absorption (e.g., levothyroxine and neutralizing antacids), elimination (e.g., digoxin and macrolides), and metabolism, as in the competition for cytochrome P450 enzymes (e.g., SSRIs and certain beta-blockers).

What medications can interact with digoxin therapy?

Cardiac patients receiving digoxin therapy are particularly prone to interactions with commonly co-administered medications such as the antiarrhythmics quinidine and amiodarone, the calcium channel blockers verapamil and nifedipine, and possibly some vasodilating agents.

Why study digoxin pharmacokinetics in the older person?

A thorough understanding of digoxin pharmacokinetics in the older person is essential for improved therapeutic outcomes, improved compliance, reduced morbidity and improved quality of life.

What is the half life of digoxin in humans?

DIGOXIN. The half life of digoxin is 1.5-2 days (36-44 hours) although this becomes prolonged in renal dysfunction [ 4, 20 – 23, 25, 26 ]. Digoxin has a volume of distribution of about 7.3 L/kg but this decreases in renal disease and hypothyroidism (increases in hyperthyroidism) [ 4 ].

Why is the therapeutic range of digoxin so narrow?

The narrow therapeutic rangeof digoxin means that small variations in blood concentration may easily result in toxic or sub therapeutic concentrations. To maintain concentrations within the therapeutic range requires consistent bioavailability and careful management of factors that may influence bioavailability.

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