Drug Interactions Newsletter

Volume 1, Issue 17, 05/12/2009

Question

Part 2: What is the average dose reduction of digoxin (Digitek®; Lanoxin®) needed when used in combination with the antiarrhythmic medication, amiodarone (Cordarone®)?

Answer

Part 2 of a 2 part series.  With the mechanism by which amiodarone increases digoxin being described in part 1, it is important to take the discussion further by looking at how much of an impact amiodarone has on digoxin concentrations, if it is clinically relevant and what clinicians should do with the dose of digoxin.   

A number of small studies and case reports have documented the increases in digoxin concentration when being administered with amiodarone.(1-5) The most common dose of amiodarone used ranged from 400 - 1600 mg per day.  This resulted in reductions in systemic or total body clearances by....

Other keywords found in this issue: non-renal clearance, renal clearance, narrow therapeutic index, serum concentrations, tissue distribution, interpretation of results, labs, pharmacokinetic, counseling points, clinical considerations

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