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Kaolin and Lanoxin Pediatric Intravenous

Determining the interaction of Kaolin and Lanoxin Pediatric Intravenous and the possibility of their joint administration.

Check result:
Kaolin <> Lanoxin Pediatric Intravenous
Relevance: 26.03.2023 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:

Using digoxin together with kaolin can decrease the effects of digoxin. Contact your doctor if your condition worsens or if you experience irregular heartbeats, fatigue or decreased heart rate. You should be advised to take kaolin at least 2 hours after digoxin if possible. You may need a dose adjustment or special tests if your use 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.

Professional:

ADJUST DOSING INTERVAL: Concurrent administration of kaolin-pectin may decrease the oral bioavailability of digitalis glycosides. The mechanism of interaction is unknown. In a single-dose study, simultaneous administration of a kaolin-pectin suspension and an oral dose of digoxin resulted in delay of absorption and a 62% reduction in the bioavailability of digoxin. Intersubject variation in digoxin bioavailability also increased more than twofold in the presence of kaolin-pectin. In contrast, administration of kaolin-pectin 2 hours before the digoxin dose had no effect on digoxin absorption rate but reduced digoxin bioavailability by 20%, while administration 2 hours after the digoxin dose neither affected the rate nor extent of absorption of digoxin. Also, no change in intersubject variability in digoxin bioavailability was observed when administration times were separated. In seven patients receiving chronic oral digoxin therapy, simultaneous administration of a kaolin-pectin antidiarrheal mixture decreased steady-state digoxin peak levels (Cmax) by 36% and the 24-hour area under the concentration-time curve (AUC) by 15%. When kaolin-pectin was administered 2 hours before or 2 hours after digoxin, no evidence of an interaction was observed. In ten healthy volunteers, administration of a single 0.75 mg dose of digoxin with kaolin-pectin significantly reduced the cumulative six-day urinary digoxin excretion (expressed as the percentage of original dose recovered) compared to administration without (23.4% vs. 40.1%). In another study, coadministration with 60 mL of a commercial kaolin-pectin suspension had no effect on the 24-hour AUC of digoxin administered as two 0.2 mg capsules or tablets, although the digoxin Cmax from both formulations was reduced, and the 24-hour digoxin urinary recovery from the tablets tended to be reduced.

MANAGEMENT: To minimize the potential for interaction, patients should be advised to take kaolin-pectin at least 2 hours after digoxin if possible. The same precaution may be applicable during therapy with digitoxin, although clinical data are lacking.

References
  • Albert KS, Ayres JW, DiSanto AR, Weidler DJ, Sakmar E, Hallmark MR, Stoll RG, DeSante KA, Wagner JG "Influence of kaolin--pectin suspension on digoxin bioavailability." J Pharm Sci 67 (1978): 1582-6
  • Marcus FI "Pharmacokinetic interactions between digoxin and other drugs." J Am Coll Cardiol 5 (1985): a82-90
  • Rodin SM, Johnson BF "Pharmacokinetic interactions with digoxin." Clin Pharmacokinet 15 (1988): 227-44
  • Brown DD, Juhl RP "Decreased bioavailability of digoxin due to antacids and kaolin-pectin." N Engl J Med 295 (1976): 1034-7
  • Allen MD, Greenblatt DJ, Harmatz JS, Smith TW "Effect of magnesium--aluminum hydroxide and kaolin--pectin on absorption of digoxin from tablets and capsules." J Clin Pharmacol 21 (1981): 26-30
Kaolin

Generic Name: kaolin

Brand name:

Synonyms: n.a.

Lanoxin Pediatric Intravenous

Generic Name: digoxin

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

Synonyms: Lanoxin

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.

Interaction with food and lifestyle