Interaction of Itraconazole and Digoxin

A 69-year-old man who had been taking digoxin for 2.5 years developed an elevated serum concentration of digoxin in association with digoxin toxicity (characterized by nausea and vomiting) 9 days after the addition of itraconazole to his regimen for the treatment of sternal osteomyelitis. Coadminist...

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Bibliographic Details
Published in:Clinical infectious diseases 1993-03, Vol.16 (3), p.400-403
Main Authors: Sachs, Mark K., Blanchard, Lourdes M., Green, Paul J.
Format: Article
Language:English
Subjects:
Adverse drug reactions
Aged
Antifungal Agents - adverse effects
Antifungals
Aspergillosis - complications
Aspergillus fumigatus
Azoles
Biological and medical sciences
Clinical Infectious Disease Articles
Digoxin - adverse effects
Digoxin - blood
Digoxin - pharmacokinetics
Dosage
Drug Interactions
Drug intoxications. Doping
Gluconates
Half lives
Half-Life
Humans
Itraconazole
Ketoconazole - adverse effects
Ketoconazole - analogs & derivatives
Least-Squares Analysis
Male
Medical sciences
Nausea
Osteomyelitis - drug therapy
Osteomyelitis - microbiology
Pharmacokinetics
Pharmacology. Drug treatments
Toxicity
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Summary:A 69-year-old man who had been taking digoxin for 2.5 years developed an elevated serum concentration of digoxin in association with digoxin toxicity (characterized by nausea and vomiting) 9 days after the addition of itraconazole to his regimen for the treatment of sternal osteomyelitis. Coadministration of itraconazole resulted in a statistically significant increase in the half-life of digoxin that necessitated a reduction of the digoxin dose by almost 60%. We thus recommend that patients receiving itraconazole and digoxin concomitantly have serum levels of digoxin monitored frequently. In addition, these patients should be carefully questioned about nonspecific gastrointestinal symptoms, which may indicate early digoxin toxicity.
ISSN:1058-4838
1537-6591
DOI:10.1093/clind/16.3.400