Digoxin Tablets and Saquinavir
Determining the interaction of Digoxin Tablets and Saquinavir and the possibility of their joint administration.
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:Talk to your doctor before using saquinavir together with digoxin. Combining these medications can increase the risk of an irregular heart rhythm that may be serious. In addition, saquinavir can 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 if your doctor does prescribe them together. You should contact your doctor if you develop sudden dizziness, lightheadedness, fainting, nausea, vomiting, loss of appetite, vision disturbances, slow pulse, or irregular heartbeat during treatment with these 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.
Professional:GENERALLY AVOID: Saquinavir in combination with ritonavir has been shown to prolong the PR interval of the electrocardiogram in some patients. Theoretically, coadministration with other agents that prolong the PR interval (e.g., beta blockers, digoxin, lacosamide, mefloquine, verapamil) may result in elevated risk of conduction disturbances and atrioventricular block. However, clinical data are lacking.
MONITOR CLOSELY: Coadministration with saquinavir may significantly increase the serum concentrations of digoxin. The mechanism of interaction has not been described but may be related to saquinavir inhibition of the P-glycoprotein-mediated renal tubular secretion of digoxin. In 16 healthy volunteers, administration of a single 0.5 mg dose of digoxin with saquinavir/ritonavir (1000 mg/100 mg twice a day for 16 days) resulted in a 27% increase in digoxin peak plasma concentration (Cmax) and a 49% increase in systemic exposure (AUC). Increases in serum digoxin concentration were greater in female subjects than in male subjects.
MANAGEMENT: Ritonavir-boosted saquinavir should generally not be used with other agents that prolong the PR interval. Extreme caution is advised if digoxin must be used concurrently with saquinavir. Serum digoxin levels should be checked frequently and the dosage adjusted accordingly, particularly following initiation or discontinuation of saquinavir in patients who are stabilized on their digoxin regimen. Patients should be advised to notify their physician if they experience signs of digoxin toxicity such as nausea, anorexia, visual disturbances, slow pulse, or irregular heartbeats.
- FDA. U.S. Food and Drug Administration "FDA drug safety communication: Ongoing safety review of Invirase (saquinavir) and possible association with abnormal heart rhythms. Available from: URL: http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm201221.h" ([2010 Feb 23]):
- Biondi L "Health Canada endorsed important safety information on Invirase (saquinavir mesylate). Available from: URL: http://hc-sc.gc.ca/dhp-mps/alt_formats/pdf/medeff/advisories-avis/prof/2010/invirase_hpc-cps-eng.pdf." ([2010 Apr 14]):
- "Product Information. Invirase (saquinavir)." Roche Laboratories, Nutley, NJ.
Generic Name: digoxin
Brand name: Digitek, Digox, Lanoxin, Lanoxicaps, Cardoxin
Synonyms: Digoxin
Generic Name: saquinavir
Brand name: Invirase, Fortovase
Synonyms: n.a.
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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