Effects of Oral Prazosin on Total Plasma Digoxin Levels

Çöpür, Sidar; Tokgözoğlu, Lâle; Oto, A.; Oram, Erdem; Uğurlu, Şevket

doi:10.1111/j.1472-8206.1988.tb00616.x

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…Concomitant therapy may alter digoxin absorption, distribution, and/or excretion. Several drug interactions have recently been reported in review articles [13,30], and, among them, clinically significant ones are listed in Table 2 [31][32][33][34][35][36][37][38][39][40][41][42][43][44].…”

Section: Drug Interactionsmentioning

confidence: 99%

“…Nifedipine [38] Prazosin [39] Propantheline [36] Quinidine [40,41] Spironolactone [42] Verapamil [43,44] [50] Increases risk of toxicity [51] Increases risk of toxicity [46] Increases risk of toxicity [48] Slightly increases risk of toxicity [49] Slightly increases risk of toxicity [61] Increases risk of toxicity [62] ably the most frequent factor contributing to digitalis toxicity• Although potassium infusions have not been shown to increase the maximum lethal dose of digoxin in experimental studies [45], and despite the fact that hypokalemia was not frequently found to be an independent risk factor for digoxin toxicity in large-scale clinical trials [5,6], there is some evidence to suggest that, in addition to having direct arrhythmogenic effects, hypokalemia decreases the threshold for digoxin toxicity [46,47]. Maintaining a serum potassium level > 4.0 mEq/L is particularly important in situations such as electrical cardioversion, where the sarcolemma is momentarily paralyzed and a loss of intracellular potassium down the chemical gradient occurs.…”

Section: -35% Decrease In Digoxin Absorptionmentioning

confidence: 99%

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How to digitalize and to maintain optimal digoxin levels in cogestive heart failure

Lambert

Rouleau

1989

Cardiovasc Drug Ther

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Due to the narrow therapeutic-to-toxic ratio of digoxin, numerous studies have been done to assess the optimal digoxin level in patients with congestive heart failure. A digoxin level of 0.7-1.5 ng/mL (or 0.9-2.0 nMol/L) is generally considered optimal, but even at these levels toxicity may occur in certain clinical situations such as severe pulmonary disease or when electrolyte or metabolic disturbances are present. The optimal daily maintenance dose of digoxin depends on the preparation given and can be calculated by the equation of Jelliffe, which is largely based on the creatinine clearance of the patient. The daily digoxin dose must also be adjusted to take into consideration disease processes or concomitant drug therapy that can alter the volume of distribution, the biotransformation, or the excretion of the drug.

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Section: Drug Interactionsmentioning

confidence: 99%

Section: -35% Decrease In Digoxin Absorptionmentioning

confidence: 99%

How to digitalize and to maintain optimal digoxin levels in cogestive heart failure

Lambert

Rouleau

1989

Cardiovasc Drug Ther

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Effects of Long‐Term Oral Carvedilol on the Steady‐State Pharmacokinetics of Oral Digoxin in Patients With Mild to Moderate Hypertension

Wermeling,

Feild,

Smith

et al. 1994

Pharmacotherapy

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The effect of multiple oral doses of carvedilol on steady‐state plasma digoxin pharmacokinetics was evaluated in 12 patients with mild to moderate hypertension. Area under the curve (AUC), mean maximum plasma concentration (Cmax), mean time to maximum concentration (Tmax), concentration at 24 hours after the dose (C24), creatinine clearance, renal digoxin clearance, and urinary digoxin excretion were determined after patients took oral digoxin 0.25 mg once/day for 2 weeks. Carvedilol was added to the regimen, and digoxin pharmacokinetics were assessed after 2 weeks of concurrent treatment. The AUC and Cmax for digoxin increased by 14% and 32%, respectively (p<0.05), with no change in Tmax. The 24‐hour urinary digoxin excretion and 24‐hour renal digoxin clearance increased by 45% and 26%, respectively (p<0.05), with no change in creatinine clearance. Carvedilol appears to increase digoxin's oral bioavailability as well as renal elimination. The absolute change in digoxin pharmacokinetics was small and not clinically significant. The significance of the interaction in other patient populations remains to be studied.

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Effects of Oral Prazosin on Total Plasma Digoxin Levels

Cited by 2 publications

References 17 publications

How to digitalize and to maintain optimal digoxin levels in cogestive heart failure

How to digitalize and to maintain optimal digoxin levels in cogestive heart failure

Effects of Long‐Term Oral Carvedilol on the Steady‐State Pharmacokinetics of Oral Digoxin in Patients With Mild to Moderate Hypertension

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