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Digoxin Intravenous and Ranolazine

Determining the interaction of Digoxin Intravenous and Ranolazine and the possibility of their joint administration.

Check result:

Digoxin Intravenous <> Ranolazine

Relevance: 21.12.2022 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:

Ranolazine may 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:

ADJUST DOSE: Coadministration with ranolazine may increase the plasma concentrations of digoxin. The mechanism is ranolazine inhibition of the P-glycoprotein-mediated efflux of digoxin in the intestine. In healthy volunteers, coadministration of ranolazine (1000 mg twice a day) and digoxin (0.125 mg once a day) resulted in a 1.5-fold increase in the plasma concentrations of digoxin. In contrast, digoxin did not increase the plasma concentrations of ranolazine, which is also a substrate of P-glycoprotein.

MANAGEMENT: Digoxin dosage may need adjustment during coadministration with ranolazine. Pharmacologic response and serum digoxin levels should be monitored more closely whenever ranolazine is added to or withdrawn from therapy, and the digoxin dosage adjusted as necessary. Patients should be advised to notify their physician if they experience signs and symptoms of digoxin toxicity such as irregular heartbeats, slow pulse, nausea, anorexia, or visual changes.

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
"Product Information. Ranexa (ranolazine)." Calmoseptine Inc, Huntington Beach, CA.
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 Intravenous

Generic Name: digoxin

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

Synonyms: Digoxin

What is Digoxin Intravenous?

Ranolazine

Generic Name: ranolazine

Brand name: Ranexa

Synonyms: n.a.

What is Ranolazine?

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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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