Digoxin Oral Solution and Ketek

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.

Using digoxin together with telithromycin can increase the effects of digoxin. This can cause pale skin, easy bruising or bleeding, unusual weakness, mouth sores, nausea, vomiting, black or bloody stools, and urinating less than usual or not at all. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or special test if you take both medications. 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.

MONITOR: Coadministration with telithromycin may increase the plasma concentrations of digoxin. The proposed mechanism is telithromycin inhibition of P-glycoprotein efflux pump in the intestine and renal proximal tubules, resulting in increased absorption and decreased excretion of digoxin. In healthy volunteers, telithromycin increased the peak plasma concentration (Cmax), trough plasma concentration (Cmin) and area under the concentration-time curve (AUC) of digoxin by 73%, 21% and 37%, respectively. However, trough plasma levels of digoxin (when equilibrium between plasma and tissue concentrations has been achieved) ranged from 0.74 to 2.17 ng/mL, and there were no significant changes in electrocardiographic parameters and no signs of digoxin toxicity in the volunteers. During postmarketing use, the interaction was suspected in a 58-year-old woman who developed digoxin toxicity while she was taking a 5-day course of telithromycin for acute bronchitis. The patient complained of general malaise and had experienced three episodes of syncope secondary to possible tachyarrhythmia prior to presentation at the emergency department. A randomly obtained (more than 6 hours after the dose) plasma digoxin level was elevated at 3.14 ng/dL, which was a 55% increase from her baseline steady-state digoxin level three months before admission. Electrocardiography showed several nonspecific repolarization anomalies, and measured cardiac markers were slightly elevated. Other risk factors that may have contributed to the patient's digoxin toxicity include renal dysfunction and electrolyte abnormalities (hypomagnesemia and slight hypokalemia). However, the temporal relationship to telithromycin administration strongly suggests an interaction.

MANAGEMENT: Pharmacologic response and serum digoxin levels should be monitored more closely whenever telithromycin 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.

Digoxin Oral Solution

Generic Name: digoxin

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

Synonyms: Digoxin

What is Digoxin Oral Solution?

Ketek

Generic Name: telithromycin

Brand name: Ketek

Synonyms: n.a.

What is Ketek?