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Lanoxin (Digoxin Injection) and Neut

Determining the interaction of Lanoxin (Digoxin Injection) and Neut and the possibility of their joint administration.

Check result:
Lanoxin (Digoxin Injection) <> Neut
Relevance: 06.12.2022 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:

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

Professional:

Concurrent administration of antacids may decrease the oral bioavailability of digoxin and digitoxin. The mechanism of interaction is unknown. In ten healthy volunteers, administration of a single 0.75 mg dose of digoxin with 60 mL of antacid containing either 4% aluminum hydroxide gel, 8% magnesium hydroxide gel, or 8% magnesium trisilicate resulted in significantly reduced urinary excretion of digoxin (expressed as the percentage of original dose recovered) compared to administration without antacid. Specifically, the cumulative six-day urinary digoxin excretion was 40.1% for control, 30.7% for aluminum hydroxide, 27.1% for magnesium hydroxide, and 29.1% for magnesium trisilicate. In an in vitro study involving absorption across a physiological membrane, cumulative absorption of digoxin 0.25 mg was reduced 11.4% by aluminum hydroxide gel, 15.3% by light magnesium carbonate, and 99.5% by magnesium trisilicate. In a case report, an approximately 50% reduction in digoxin systemic exposure (AUC) was observed when digoxin was administered with 30 mL of an aluminum-magnesium hydroxide antacid and mexiletine. The interaction was attributed to the antacid, as mexiletine is not known to interact with digoxin. Some data also support a potential interaction with digitoxin. However, other studies have found no evidence of a significant interaction between digoxin and various antacids. Based on existing evidence, no special precautions appear necessary, although patients may consider separating the times of administration by 1 to 2 hours if an interaction is suspected.

References
  • Marcus FI "Pharmacokinetic interactions between digoxin and other drugs." J Am Coll Cardiol 5 (1985): a82-90
  • D'Arcy PF, McElnay JC "Drug-antacid interactions: assessment of clinical importance." Drug Intell Clin Pharm 21 (1987): 607-17
  • Brown DD, Juhl RP "Decreased bioavailability of digoxin due to antacids and kaolin-pectin." N Engl J Med 295 (1976): 1034-7
  • Saris SD, Lowenthal DT, Affrime MB "Steady-state digoxin concentration during oral mexiletine administration." Curr Ther Res Clin Exp 34 (1983): 662-6
  • McElnay JC, Harron DW, D'Arcy PF, Eagle MR "Interaction of digoxin with antacid constituents." Br Med J 1 (1978): 1554
  • 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
  • Bonelli J, Hruby K, Magometschnigg D, Hitzenberger G, Kaik G "The bio-availability of beta-acetyldigoxine alone and combined with aluminum hydroxide and magnesium hydroxide (Alucol)." Int J Clin Pharmacol Biopharm 15 (1977): 337-9
  • Rodin SM, Johnson BF "Pharmacokinetic interactions with digoxin." Clin Pharmacokinet 15 (1988): 227-44
Lanoxin (Digoxin Injection)

Generic Name: digoxin

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

Synonyms: Lanoxin

Neut

Generic Name: sodium bicarbonate

Brand name: Neut

Synonyms: Neut Injection

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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Disease interaction