Interaction between digoxin and indomethacin or ibuprofen.

Abstract

To study a potential interaction between digoxin and two non‐steroid anti‐inflammatory drugs, indomethacin (50 mg three times daily) and ibuprofen (600 mg three times daily) were given for 10 days to 10 and 8 patients, respectively, on chronic digoxin treatment. Serum digoxin measured by fluorescence polarisation immunoassay increased significantly (P less than 0.05) during treatment with indomethacin from pre‐treatment values of 0.73 +/− 0.34 nmol l‐1 (mean +/− s.d.) to a mean value of 1.02 +/− 0.43 nmol l‐1, while administration of ibuprofen did not change the steady state serum concentration of digoxin. The result demonstrates that some non‐steroidal anti‐ inflammatory drugs such as indomethacin increase serum digoxin to levels high in the therapeutic range. This should be taken into consideration when co‐administering other drugs known to increase the serum concentration of digoxin such as several antiarrhythmics.

Role of Organic Anion Transporting Polypeptide 2 in Pharmacokinetics of Digoxin and β-Methyldigoxin in Rats

“…Oatp2 is predominantly expressed at the sinusoidal membrane in perivenous hepatocytes, and in the brain and retina to some extent 19–22. Some Oatp2‐related compounds, such as indomethacin and amiodarone, also cause drug interactions with digoxin in humans 23–26. The interaction of digoxin with indomethacin has been found in infants, elderly, or patients with renal failure, which resulted in a significant elevation of serum digoxin levels 25–27.…”

“…Some Oatp2‐related compounds, such as indomethacin and amiodarone, also cause drug interactions with digoxin in humans 23–26. The interaction of digoxin with indomethacin has been found in infants, elderly, or patients with renal failure, which resulted in a significant elevation of serum digoxin levels 25–27. The interaction with amiodarone has been observed even in normal subjects under usual dosage regimen, in which renal and nonrenal clearances of digoxin are reduced significantly 23,24,28–30.…”

Medication overuse and chronic migraine: a critical review according to clinical pharmacology

“…Decreased renal clearance of digoxin Monitor digoxin serum levels and patients for signs of toxicity [107] NSAIDs/herbs with anticoagulants/antiplatelet properties (ginkgo, garlic, ginger, bilberry, dong quai, feverfew, ginseng, turmeric, meadowsweet and willow, chamomile, motherworth, horse chestnut, fenugreek and red clover, tamarind)…”

Primer consenso clínico de SIBEN: enfoque diagnóstico y terapéutico del ductus arterioso permeable en recién nacidos pretérmino

“…La preparación diluida debe ser administrada inmediatamente y el remanente debe ser descartado. La indometacina puede prolongar la vida media de digoxina, amikacina y gentamici-na [114][115][116][117][118][119][120][121][122] y es incompatible con aminoácidos, gluconato cálcico, dobutamina, dopamina y gentamicina. Es compatible con furosemida, insulina, cloruro potásico y bicarbonato de sodio 123 .…”