Intoxication due to negative canrenone interference in digoxin drug monitoring

Canrenone and spironolactone caused falsely low readings in a common assay for digoxin (AxSym MEIA) due to negative cross-reactivity. Misleading subtarget concentrations were repeatedly reported, and falsely guided drug dosing resulted in a case of digoxin intoxication.

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Bibliographic Details
Published in:The Lancet (British edition) 1999-10, Vol.354 (9185), p.1176-1177
Main Authors: Steimer, Werner, Müller, Christine, Eber, Barbara, Emmanuilidis, Klaus
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Canrenone - blood
Cardiac arrhythmia
Cross-reactivity
Digoxin
Digoxin - blood
Digoxin - poisoning
Drug dosages
Drug Interactions
Drug intoxications. Doping
Drug Monitoring - methods
Enzyme Multiplied Immunoassay Technique
Fatal Outcome
Humans
Intoxication
Male
Medical sciences
Medication Errors
Multiple Organ Failure - etiology
Patients
Pharmacology. Drug treatments
Potassium
Sepsis - complications
Spironolactone - blood
Therapeutic drug monitoring
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Description
Summary:Canrenone and spironolactone caused falsely low readings in a common assay for digoxin (AxSym MEIA) due to negative cross-reactivity. Misleading subtarget concentrations were repeatedly reported, and falsely guided drug dosing resulted in a case of digoxin intoxication.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(99)03818-0