Digoxin and Mavyret

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.

Glecaprevir may increase the blood levels and effects of digoxin. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek medical attention if you experience nausea, vomiting, diarrhea, loss of appetite, visual disturbances (blurred vision; light halos around objects; green or yellow vision), or an abnormally fast or slow or uneven heartbeat, as these may be signs and symptoms of excessive digoxin levels. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

ADJUST DOSE: Coadministration with glecaprevir-pibrentasvir may increase the serum concentrations of digoxin. The proposed mechanism is inhibition of the P-glycoprotein (P-gp)-mediated intestinal efflux or renal tubular secretion of digoxin by glecaprevir and pibrentasvir, both of which are inhibitors of the transporter. In 12 study subjects, administration of a single 0.5 mg dose of digoxin with glecaprevir-pibrentasvir 400 mg-120 mg once daily increased digoxin peak plasma concentration (Cmax) and systemic exposure (AUC) by 72% and 48%, respectively, compared to administration of digoxin alone.

MANAGEMENT: Serum digoxin levels and pharmacologic effects should be closely monitored following the addition or withdrawal of glecaprevir-pibrentasvir. The manufacturer recommends measuring serum digoxin levels before initiating glecaprevir-pibrentasvir and reducing the levels by decreasing the digoxin dose approximately 50% or by modifying the dosing frequency, followed by continued monitoring. Patients should be advised to seek medical attention if they experience signs of digoxin toxicity such as nausea, anorexia, visual disturbances, slow pulse, or irregular heartbeat.

Digoxin

Generic Name: digoxin

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

Synonyms: n.a.

What is Digoxin?

Mavyret

Generic Name: glecaprevir / pibrentasvir

Brand name: Mavyret

Synonyms: n.a.

What is Mavyret?