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Interaction Between Digoxin and Antiarrhythmic, Diuretic, or Vasodilator Drugs

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Myocarditis Cardiomyopathy

Part of the book series: International Boehringer Mannheim Symposia ((BOEHRINGER))

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Abstract

Patients with cardiomyopathy often receive multiple medicines, including digitalis, diuretics, antiarrhythmic agents, and vasodilators. Digitalis pharmacokinetics are altered by several of these drugs and these interactions are important. In the past few years the pharmacokinetic interaction of digoxin with quinidine has been discovered and there has been considerable progress in understanding the mechanism of this interaction. In addition, interaction of digoxin with amiodarone and with verapamil has been reported. Spironolactone has been shown to increase serum digoxin levels. Finally, there is data on an interaction between digitalis and vasodilator drugs.

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References

  1. Koster RW, Wellens HJJ (1976) Quinidine-induced ventricular flutter and fibrillation without digitalis therapy. Am J Cardiol 38: 519–523

    Article  PubMed  CAS  Google Scholar 

  2. Ejvinsson G (1978) Effect of quinidine on plasma concentrations of digoxin. Br Med J 1: 279–280

    Article  PubMed  CAS  Google Scholar 

  3. Doering W, König E (1978) Anstieg der Digoxinkonzentration im Serum unter Chinidinmedikation. Med Klin 73: 1085–1088

    PubMed  CAS  Google Scholar 

  4. Leahey EB Jr, Reiffei JA, Drusin RE, Heissenbuttel RH, Lovejoy WP, Bigger JT Jr (1978) Interaction between quinidine and digoxin. JAMA 240: 533–534

    Article  PubMed  Google Scholar 

  5. Leahey EB Jr, Reiffei JA, Heissenbuttel RH, Drusin RE, Lovejoy WP, Bigger JT Jr (1979) Enhanced cardiac effect of digoxin during quinidine treatment. Arch Intern Med 139: 519–521

    Article  PubMed  Google Scholar 

  6. Hager WD, Fenster P, Mayersohn M, Perrier D, Graves P, Marcus FI, Goldman S (1979) Digoxinquinidine interaction. N Engl J Med 300: 1238–1241

    Article  PubMed  CAS  Google Scholar 

  7. Doering W (1979) Quinidinedigoxin interaction. N Engl J Med 301: 400–404

    Article  PubMed  CAS  Google Scholar 

  8. Risler T, Peters U, Grabensee B, Seipel L (1979) Untersuchungen zur Interaktion von Chinidin und Digoxin beim Menschen. Dtsch Med Wochen- schr 104: 1523–1526

    Article  CAS  Google Scholar 

  9. Mungall DR, Robichaux RP, Perry W, Scott JW, Robinson A, Burelle T, Hurst D (1980) Effects of quinidine on serum digoxin concentration. Ann Intern Med 93: 689–693

    PubMed  CAS  Google Scholar 

  10. Pedersen KE, Hastrup J, Hvidt S (1980) The effect of quinidine on digoxin kinetics in cardiac patients. Acta Med Scand 207: 291–295

    Article  PubMed  CAS  Google Scholar 

  11. Dahlqvist R, Ejvinsson G, Schenck-Gustafsson K (1980) Effect of quinidine on plasma concentration and renal clearance of digoxin. A clinically important drug interaction. Br J Clin Pharmacol 9: 413–418

    Google Scholar 

  12. Hooymans PM, Merkus FWHM (1978) Effect of quinidine on plasma con-centration of digoxin. Br Med J 2: 1022

    Article  PubMed  CAS  Google Scholar 

  13. Schenck-Gustafsson K, Dahlqvist R (1981) Pharmacokinetics of digoxin in patients subjected to the quinidine-digoxin interaction. Br J Clin Pharmacol 11: 181–186

    PubMed  CAS  Google Scholar 

  14. Powell JR, Fenster PE, Hager WD, Graves PE, Conrad KE, Gaines JA, Finley PR, Goldman S, Marcus FI Digoxin interaction: Dose dependence and time course. Clin Pharmacokinetics (in press)

    Google Scholar 

  15. Schenck-Gustafsson K, Jogestrand T, Nordlander R, Dahlqvist R (1981) Effect of quinidine on digoxin concentration in skeletal muscle and serum in patients with atrial fibrillation. N Engl J Med 305: 209–211

    Article  PubMed  CAS  Google Scholar 

  16. Moysey JO, Jaggarao NSV, Grundy EN, Chamberlain DA (1981) Amiodarone increases plasma digoxin concentrations. Br Med J 282: 272

    Article  CAS  Google Scholar 

  17. Klein HO, Lang R, DiSegni E, Kaplinsky E (1980) Verapamil-digoxin interaction ( Letter to the Editor ). N Engl J Med 303: 160

    Google Scholar 

  18. Leahey EB Jr, Reiffei JA, Giardina EV, Bigger JT Jr (1980) The effect of quinidine and other oral antiarrhythmic drugs on serum digoxin. Ann Intern Med 92: 605 - 608

    PubMed  Google Scholar 

  19. Waldorff S, Andersen JD, Heeboll-Nielsen N, Nielsen OG, Molthe E, Sorensen U, Steiness E (1978) Spironolactone-induced changes in digoxin kinetics. Clin Pharmacol Ther 24: 162–167

    PubMed  CAS  Google Scholar 

  20. Steiness E (1974) Renal tubular secretion of digoxin. Circulation 50: 103–107

    PubMed  CAS  Google Scholar 

  21. Masson JP, Bass O, Baur HR, Ohnhaus EE (1978) Zur Eliminationskinetik des Digoxin vor und während Spironolacton Behandlung. Klin Wochenschr 56: 1071–1076

    Article  PubMed  CAS  Google Scholar 

  22. Cogan JJ, Humphreys MH, Carlson J, Rapaport E (1980) Digoxin: The acute effects of vasodilator therapy on renal metabolism [Abstr] Am J Cardiol 45: 412

    Google Scholar 

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© 1983 Springer-Verlag Berlin Heidelberg

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Marcus, F.I. (1983). Interaction Between Digoxin and Antiarrhythmic, Diuretic, or Vasodilator Drugs. In: Just, H., Schuster, H.P. (eds) Myocarditis Cardiomyopathy. International Boehringer Mannheim Symposia. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-68608-5_26

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  • DOI: https://doi.org/10.1007/978-3-642-68608-5_26

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-11617-2

  • Online ISBN: 978-3-642-68608-5

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