Drug search by name

Digoxin and Sporanox PulsePak

Determining the interaction of Digoxin and Sporanox PulsePak and the possibility of their joint administration.

Check result:

Digoxin <> Sporanox PulsePak

Relevance: 18.05.2023 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:

Itraconazole may significantly increase the blood levels and effects of digoxin. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor 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.

Professional:

MONITOR CLOSELY: Coadministration with itraconazole may significantly increase the serum concentrations of digoxin. The proposed mechanism is inhibition of the P-glycoprotein-mediated intestinal efflux or renal tubular secretion of digoxin by itraconazole, a potent inhibitor of the transporter. In two pharmacokinetic studies, mean digoxin systemic exposure (AUC) was increased by 50% and 80% when coadministered with itraconazole compared to placebo. Two- to fourfold increases in digoxin concentrations have also been reported in some cases following initiation of itraconazole. Toxicity has occurred, most with an onset of 9 to 13 days following the start of itraconazole therapy. Digoxin dosage reductions of 60% to 75% were required in some cases.

MANAGEMENT: Caution is advised when digoxin is administered with itraconazole. The prescribing information for digoxin recommends decreasing the dosage by approximately 30% to 50% or modifying the dosing frequency when initiating itraconazole, followed by continued therapeutic monitoring of digoxin. 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.

References

Balayssac D, Authier N, Cayre A, Coudore F "Does inhibition of P-glycoprotein lead to drug-drug interactions?" Toxicol Lett 156 (2005): 319-29
Partanen J, Jalava KM, Neuvonen PJ "Itraconazole increases serum digoxin concentration." Pharmacol Toxicol 79 (1996): 274-6
Alderman CP, Jersmann HP "Digoxin-itraconazole interaction." Med J Aust 159 (1993): 838-9
Mathis AS, Friedman GS "Coadministration of digoxin with itraconazole in renal transplant recipients." Am J Kidney Dis 37 (2001): u101-8
Alderman CP, Allcroft PD "Digoxin-itraconazole interaction: possible mechanisms." Ann Pharmacother 31 (1997): 438-40
Rex J "Itraconazole-digoxin interaction." Ann Intern Med 116 (1992): 525
Sachs MK, Blanchard LM, Green PJ "Interaction of itraconazole and digoxin." Clin Infect Dis 16 (1993): 400-3
Cone LA, Himelman RB, Hirschberg JN, Hutcheson JW "Itraconazole-related amaurosis and vomiting due to digoxin toxicity." West J Med 165 (1996): 322
Kauffman CA, Bagnasco FA "Digoxin toxicity associated with itraconazole therapy." Clin Infect Dis 15 (1992): 886-7
Mcclean KL, Sheehan GJ "Interaction between itraconazole and digoxin." Clin Infect Dis 18 (1994): 259-60
Ito S, Koren G "Possible mechanism of digoxin-itraxonazole interaction." Ann Pharmacother 31 (1997): 1091-2
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

Digoxin

Generic Name: digoxin

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

Synonyms: n.a.

What is Digoxin?

Sporanox PulsePak

Generic Name: itraconazole

Brand name: Sporanox, Onmel, Sporanox PulsePak, Tolsura

Synonyms: Sporanox

What is Sporanox PulsePak?

+ Add a drug Remove all

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.

The list of popular interactions