Kaletra and Lanoxin

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.

Ritonavir 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.

MONITOR: Coadministration with ritonavir may increase serum digoxin concentrations and the risk of digoxin toxicity. The proposed mechanism is reduced clearance of digoxin due to ritonavir inhibition of p-glycoprotein-mediated renal tubular secretion. In 12 healthy volunteers, pretreatment with ritonavir (300 mg orally twice daily) for 3 days increased the area under the plasma concentration-time curve (AUC) and volume of distribution of digoxin (0.5 mg single IV dose) by 86% and 77%, respectively, compared to placebo. Nonrenal and renal digoxin clearance decreased by 48% and 35%, respectively, while plasma terminal half-life increased by 156%. In an isolated case report, a 61-year-old woman on a stable regimen of digoxin (0.25 mg/day), warfarin, aerosolized pentamidine, lamivudine, stavudine, and indinavir developed digoxin toxicity (7.2 nmol/L) 3 days after ritonavir 200 mg twice a day was added to her regimen. The patient experienced nausea and vomiting, and digoxin was permanently discontinued without sequelae.

MANAGEMENT: Caution is advised if digoxin must be used in combination with ritonavir. Pharmacologic response and serum digoxin levels should be monitored more closely whenever ritonavir is added to or withdrawn from therapy, and the digoxin dosage adjusted as necessary.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 potential signs and symptoms of digoxin toxicity such as nausea, anorexia, visual disturbances, slow pulse, or irregular heartbeats.

Kaletra

Generic Name: lopinavir / ritonavir

Brand name: Kaletra

Synonyms: n.a.

What is Kaletra?

Lanoxin

Generic Name: digoxin

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

Synonyms: n.a.

What is Lanoxin?