Pharmacodynamics and pharmacokinetics of digoxin in the presence of lithium.

Abstract

Previous biochemical and clinical data suggest there may be an interaction between digoxin and lithium. The pharmacodynamics and pharmacokinetics of an intravenous infusion of digoxin were studied in six male subjects before and after 2 weeks treatment with lithium carbonate. The effects of lithium on sodium pump activity, intracellular electrolytes and extracellular electrolytes were studied. No significant interaction between digoxin and lithium was found. No significant effects of lithium on sodium pump activity or electrolyte concentrations were found.

Teriparatide has no effect on the calcium‐mediated pharmacodynamics of digoxin

“…The subjects in this study responded as expected to digoxin with STI and heart rate changes that conformed to the patterns previously reported in healthy volunteers in the literature. [11][12][13][14]24 The mean decrease in QS 2 c (⌬QS 2 c) after dosing to steady state with digoxin was 23.9 ms (6.4% of predigoxin mean), which agrees well with values found in the literature. [14][15][16]26,27 For example, Belz et al 28 studied healthy volunteers given digoxin, 0.3 mg daily, for 10 days (mean trough serum digoxin concentration, 1.3 ng/mL) and found a mean ⌬QS 2 c of 21 ms. Carliner et al 26 gave patients digoxin, 0.5 mg daily, for 14 days (mean trough serum digoxin concentration, 0.88 ng/mL) and measured a ⌬QS 2 c of 23 ms.…”

“…10 These measures have been assessed by investigators in healthy volunteers over the last 30 years and have consistently been shown to correlate with tissue digoxin levels. [11][12][13][14] Furthermore, they have previously been used to design interaction studies of digoxin with other medications in healthy volunteers. 15,16 Because the mechanism of action of digoxin is mediated by calcium and increases in serum calcium concentrations shorten STIs, 17 STI evaluation is a useful pharmacodynamic measure to evaluate a potential digoxin-calcium interaction.…”

Psychotropic and Medical Drug Interactions

“…Cooper et al [72] gave intravenous infusion of digoxin to healthy volunteers who had taken lithium for 2 weeks prior to the infusion and had a steady-state plasma level of 0.76 mEq/1. No interaction was evident.…”