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Cordarone IV Intravenous and Lanoxicaps

Determining the interaction of Cordarone IV Intravenous and Lanoxicaps and the possibility of their joint administration.

Check result:

Cordarone IV Intravenous <> Lanoxicaps

Relevance: 15.03.2023 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:

Before taking amiodarone, tell your doctor if you also use digoxin. You may need dose adjustments or special tests in order to safely take both medications together. This combination may lead to higher blood levels of digoxin. Digoxin levels should be closely checked if you start on amiodarone. You should notify your doctor if you have symptoms of high digoxin levels such as nausea, decrease of appetite, visual disturbances, slow pulse, or irregular heartbeats. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using your medications without first talking to your doctor first.

Professional:

ADJUST DOSE: Coadministration with amiodarone may increase serum digoxin concentrations by up to 100%, frequently resulting in clinical toxicity. In children, this percentage may be even higher. Amiodarone has been suggested to increase intestinal transit time, reduce renal clearance and volume of distribution, displace digoxin from protein binding sites, as well as induce hypothyroidism, all of which may contribute to increased serum digoxin levels. In addition, both drugs may have additive bradycardic effects. Torsade de pointes cardiac arrhythmia has been reported. The interaction also has occurred with digitoxin.

MANAGEMENT: The need for continued digitalis therapy should be evaluated if amiodarone is prescribed to patients treated with digitalis. Empirical reduction of digitalis dosage by one-third to one-half should be considered in patients who require concomitant treatment with these drugs. Serum digitalis levels should be closely monitored and patients observed for clinical evidence of toxicity. Patients should be advised to seek medical attention if they experience signs of digitalis toxicity such as nausea, anorexia, visual disturbances, slow pulse, or irregular heartbeats.

References

Mingardi G "Amiodarone and plasma digoxin levels." Lancet 1 (1984): 1238
Fenster PE, White NW, Jr Hanson CD "Pharmacokinetic evaluation of the digoxin-amiodarone interaction." J Am Coll Cardiol 5 (1985): 108-12
Bajaj BP, Baig MW, Perrins EJ "Amiodarone-induced torsades de pointes: the possible facilitatory role of digoxin." Int J Cardiol 33 (1991): 335-7
Koren G, Hesslein PS, MacLeod SM "Digoxin toxicity associated with amiodarone therapy in children." J Pediatr 104 (1984): 467-70
Freitag D, Bebee R, Sunderland B "Digoxin-quinidine and digoxin-amiodarone interactions: frequency of occurrence and monitoring in australian repatriation hospitals." J Clin Pharm Ther 20 (1995): 179-83
Oetgen WJ, Sobol SM, Tri TB, Heydorn WH, Rakita L "Amiodarone-digoxin interaction: clinical and experimental observations." Chest 86 (1984): 75-9
Kerin NZ, Aragon E, Faitel K, Frumin H, Rubenfire M "Long-term efficacy and toxicity of high- and low-dose amiodarone regimens." J Clin Pharmacol 29 (1989): 418-23
Klein HO, Beker B, DiSegni E, Kaplinsky E "Asystole produced by the combination of amiodarone and digoxin." Am Heart J 113 (1987): 399-400
Wilson JS, Podrid PJ "Side effects from amiodarone." Am Heart J 121 (1991): 158-71
Rodin SM, Johnson BF "Pharmacokinetic interactions with digoxin." Clin Pharmacokinet 15 (1988): 227-44
Moysey JO, Jaggarao NS, Grundy EN, Chamberlain DA "Amiodarone increases plasma digoxin concentrations." Br Med J (Clin Res Ed) 282 (1981): 272
Drescher S, Glaeser H, Murdter T, Hitzl M, Eichelbaum M, Fromm MF "P-glycoprotein-mediated intestinal and biliary digoxin transport in humans." Clin Pharmacol Ther 73 (2003): 223-31
"Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
Laer S, Scholz H, Buschmann I, Thoenes M, Meinertz T "Digitoxin intoxication during concomitant use of amiodarone." Eur J Clin Pharmacol 54 (1998): 95-6
McGovern B, Garan H, Kelly E, Ruskin JN "Adverse reactions during treatment with amiodarone hydrochloride." Br Med J (Clin Res Ed) 287 (1983): 175-80
Marcus FI "Pharmacokinetic interactions between digoxin and other drugs." J Am Coll Cardiol 5 (1985): a82-90
Gill J, Heel RC, Fitton A "Amiodarone: an overview of its pharmacological properties, and review of its therapeutic use in cardiac arrhythmias." Drugs 43 (1992): 69-110
Nademanee K, Kannan R, Hendrickson J, Ookhtens M, Kay I, Singh BN "Amiodarone-digoxin interaction: clinical significance, time course of development, potential pharmacokinetic mechanisms and therapeutic implications." J Am Coll Cardiol 4 (1984): 111-6
Ben-Chetrit E, Ackerman Z, Eliakim M "Amiodarone-associated hypothyroidism--a possible cause of digoxin intoxication." Am J Med Sci 289 (1985): 114-6

Cordarone IV Intravenous

Generic Name: amiodarone

Brand name: Pacerone, Cordarone, Nexterone

Synonyms: Cordarone IV (Intravenous)

What is Cordarone IV Intravenous?

Lanoxicaps

Generic Name: digoxin

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

Synonyms: Lanoxicaps (Oral)

What is Lanoxicaps?

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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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