|
|
||||||||||
|
J Am Coll Cardiol, 1984; 4:111-116 © 1984 by the American College of Cardiology Foundation |
Administration of amiodarone (600 to 1,600 mg/day) to 28 patients during long-term digoxin therapy (0.25 +/- 0.05 mg/day) increased serum digoxin level from 0.97 +/- 0.45 to 1.98 +/- 0.84 ng/ml (p less than 0.001). Gastrointestinal side effects occurred in nine patients, central nervous system reactions occurred in five and cardiovascular reactions occurred in four. Pharmacokinetic studies in six patients with a 1 mg intravenous digoxin dose before and during amiodarone therapy increased serum digoxin level at 30 minutes from 8.59 +/- 1.68 to 10.07 +/- 1.70 ng/ml (p less than 0.05). Amiodarone caused a 31% prolongation of digoxin elimination half-life from 49.5 +/- 8.8 to 65.0 +/- 28.8 hours, but the increase in half-life was not statistically significant. Total body clearance was reduced significantly (29%, p less than 0.05) from 2.05 +/- 0.76 to 1.46 +/- 0.64 ml/min per kg. Nonrenal clearance also showed a significant decrease (33%, p less than 0.05) from 1.20 +/- 0.46 to 0.80 +/- 0.30 ml/min per kg. The renal clearance decreased by 22% and the volume of distribution decreased by 11% after amiodarone therapy, but these changes were not significant. The data show that the mechanism of digoxin-amiodarone interaction is multifactorial and emphasize the need for close monitoring of serum digoxin levels and clinical features during concurrent digoxin-amiodarone therapy.
This article has been cited by other articles:
![]() |
S. de Denus and S. A. Spinler Optimal Digoxin Concentrations for Patients With Heart Failure JAMA, May 28, 2003; 289(20): 2643 - 2643. [Full Text] [PDF] |
||||
![]() |
H. Tanaka, K. Matsumoto, K. Ueno, M. Kodama, K. Yoneda, Y. Katayama, and K. Miyatake Effect of Clarithromycin on Steady-State Digoxin Concentrations Ann. Pharmacother., February 1, 2003; 37(2): 178 - 181. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. F. Fromm, R. B. Kim, C. M. Stein, G. R. Wilkinson, and D. M. Roden Inhibition of P-Glycoprotein–Mediated Drug Transport : A Unifying Mechanism to Explain the Interaction Between Digoxin and Quinidine Circulation, February 2, 1999; 99(4): 552 - 557. [Abstract] [Full Text] [PDF] |
||||
![]() |
Y.-G. Li and S. H. Hohnloser Clinical Review : Update on Atrial Fibrillation: Restoration of Sinus Rhythm or Ventricular Rate Control? Journal of Cardiovascular Pharmacology and Therapeutics, January 1, 1998; 3(2): 185 - 194. [Abstract] [PDF] |
||||
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |