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Effect of cisapride and metoclopramide on digoxin bioavailability

Summary

Pharmacokinetics of digoxin were investigated in six healthy volunteers following one week of digoxin monotherapy 0.25 mg b.i.d., and during coadministration of metoclopramide 10 mg t.i.d. or cisapride 10 mg t.i.d.. Metoclopramide reduced the peak plasma concentration of digoxin from 1.5±0.2 ng/ml to 1.1±0.1 ng/ml (mean±SEM) (p=0.05), cisapride lowered the peak concentration to 1.3±0.1 ng/ml (p=0.14). Metoclopramide prolonged the time required to reach the peak concentration of digoxin from 2 hr to 2.7 hr (p=0.17), cisapride did not. Digoxin AUC0–12 (743±79 ng/ml.min) was reduced by 12% on coadministration of-cisapride (653±3 8 ng/ml.min, p=0.22) and by 19% on coadministration of metoclopramide (605±3 4 ng/ml.min, p=0.06).

It is concluded that the gastrointestinal absorption of digoxin is reduced by both substances. Monitoring of the patient’s clinical status should be recommended when metoclopramide and cisapride are coadministered.

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References

  1. 1.

    Manninen, V., Melin, J., Apajalahti, A., Karesoja, M. (1973): Altered absorption of digoxin in patients given propantheline and metoclopramide. Lanceti, 398–399.

  2. 2.

    Regardh, C.G., Lundborg, P., Persson, B.A. (1981): The effect of antacid, metoclopramide, and propantheline on the bioavailability of metoprolol and atenolol. Biopharm. Drug Disp.2, 79–87.

  3. 3.

    Johnson, B.F., Bustrack, J.A., Urbach, D.R., Hut, J.H., Marwaha, R. (1984): Effect of metoclopramide on digoxin absorption from tablets and capsules. Clin. Pharmacol. Ther.36, 724–730.

  4. 4.

    Van Nueten, J.M., Schuurkes, J.A.J. (1984): Stimulating effects of cisapride on isolated preparations of stomach, small and large intestine of the guinea pig. Gastroenterology86, 1288–1293.

  5. 5.

    Schuurkes, J.A.J., Akkermans, L.M.A., Van Nueten, J.M. (1984): Stimulating effects of cisapride on antroduodenal motility in the conscious dog. Gastroenterology86, 1240–1245.

  6. 6.

    Reyntjens, A., Verlinden, M., Schuurkes, J., Van Nueten, J., Janssen P.A.J. (1984): Newapproach to gastrointestinal motor dysfunction: non-antidopaminergic, non-cholinergic stimulation with cisapride. An introductory survey. Curr. Ther. Res.36, 1029–1037.

  7. 7.

    Corazziari, E., Bontempo, I., Anzini, F. (1984): Effect of cisapride on primary peristalsis and lower esophageal sphincter (LES) pressure. Gastroenterology86, 1054–1059.

  8. 8.

    Lee, K.Y., Chey, W.Y., You, CH., Shah, A.N., Hamilton D. ( 1984): Effect of cisapride on the motility of gut in dogs and colonic transit time in dogs and humans. Gastroenterology86, 1157–1164.

  9. 9.

    SAS User’s Guide Statistics: 1982 Edition, SAS Institute Inc., Cary, N.C.

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Correspondence to W. Kirch.

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Kirch, W., Janisch, H.D., Santos, S.R. et al. Effect of cisapride and metoclopramide on digoxin bioavailability. European Journal of Drug Metabolism and Pharmacokinetics 11, 249–250 (1986). https://doi.org/10.1007/BF03189108

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Key words

  • Digoxin
  • cipapride
  • metoclopramide
  • pharmacokinetics
  • interaction