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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Koster RW, Wellens HJJ (1976) Quinidine-induced ventricular flutter and fibrillation without digitalis therapy. Am J Cardiol 38: 519–523
Ejvinsson G (1978) Effect of quinidine on plasma concentrations of digoxin. Br Med J 1: 279–280
Doering W, König E (1978) Anstieg der Digoxinkonzentration im Serum unter Chinidinmedikation. Med Klin 73: 1085–1088
Leahey EB Jr, Reiffei JA, Drusin RE, Heissenbuttel RH, Lovejoy WP, Bigger JT Jr (1978) Interaction between quinidine and digoxin. JAMA 240: 533–534
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
Hager WD, Fenster P, Mayersohn M, Perrier D, Graves P, Marcus FI, Goldman S (1979) Digoxinquinidine interaction. N Engl J Med 300: 1238–1241
Doering W (1979) Quinidinedigoxin interaction. N Engl J Med 301: 400–404
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
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
Pedersen KE, Hastrup J, Hvidt S (1980) The effect of quinidine on digoxin kinetics in cardiac patients. Acta Med Scand 207: 291–295
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
Hooymans PM, Merkus FWHM (1978) Effect of quinidine on plasma con-centration of digoxin. Br Med J 2: 1022
Schenck-Gustafsson K, Dahlqvist R (1981) Pharmacokinetics of digoxin in patients subjected to the quinidine-digoxin interaction. Br J Clin Pharmacol 11: 181–186
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)
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
Moysey JO, Jaggarao NSV, Grundy EN, Chamberlain DA (1981) Amiodarone increases plasma digoxin concentrations. Br Med J 282: 272
Klein HO, Lang R, DiSegni E, Kaplinsky E (1980) Verapamil-digoxin interaction ( Letter to the Editor ). N Engl J Med 303: 160
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
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
Steiness E (1974) Renal tubular secretion of digoxin. Circulation 50: 103–107
Masson JP, Bass O, Baur HR, Ohnhaus EE (1978) Zur Eliminationskinetik des Digoxin vor und während Spironolacton Behandlung. Klin Wochenschr 56: 1071–1076
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
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1983 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
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
Download citation
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
eBook Packages: Springer Book Archive