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AtroPen and Digitek

Determining the interaction of AtroPen and Digitek and the possibility of their joint administration.

Check result:
AtroPen <> Digitek
Relevance: 03.09.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

Professional:

Anticholinergic agents may increase the absorption and oral bioavailability of some digoxin formulations. The proposed mechanism involves increased gastrointestinal transit time due to reduction of stomach and intestinal motility by anticholinergic agents. In one study, coadministration with propantheline (15 mg three times a day for 10 days) led to a 30% mean increase in serum digoxin levels in 9 of 13 elderly women receiving a slow-dissolution formulation of digoxin. The interaction has also been reported with formulations containing large particle size digoxin. Other studies have found no significant effect of propantheline on digoxin elixir, solution in capsules, rapid-dissolution tablets, and micronized digoxin tablets. Therefore, the interaction is not expected to occur with most digoxin products used today in industrialized countries (e.g., Lanoxin). Due to the drug's narrow therapeutic index, however, clinicians may consider monitoring patients more closely for digoxin side effects and toxicity during coadministration with anticholinergic agents. Patients should be advised to notify their physician if they experience potential signs and symptoms of digoxin toxicity such as nausea, anorexia, visual disturbances, slow pulse, and irregular heartbeats.

References
  • Johnson BF, O'Grady J, Bye C "The influence of digoxin particle size on absorption of digoxin and the effect of propantheline and metoclopramide." Br J Clin Pharmacol 5 (1978): 465-7
  • Brown DD, Schmid J, Long RA, Hull JH "A steady-state evaluation of the effects of propantheline bromide and cholestyramine on the bioavailability of digoxin when administered as tablets or capsules." J Clin Pharmacol 25 (1985): 360-4
  • Manninen V, Apajalahti A, Simonen H, Reissell P "Effect of propantheline and metoclopramide on absorption of digoxin." Lancet 1 (1973): 1118-9
  • Binnion PF, McDermott M, LeSher D "Bioavailability of digoxin." Lancet 1 (1973): 1118
  • "Product Information. Lanoxicaps (digoxin)." Glaxo Wellcome, Research Triangle Park, NC.
AtroPen

Generic Name: atropine

Brand name: AtroPen, Sal-Tropine, Atreza

Synonyms: n.a.

Digitek

Generic Name: digoxin

Brand name: Digitek, Digox, Lanoxin, Lanoxicaps, Cardoxin

Synonyms: Digitek (Oral)

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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