Possible Interaction: Digoxin and Digitalis

“Patients on digitalis showed a further lowering of the extremely decreased EF (- 1%), but in patients with moderately decreased EF, digoxin produced a marked increase in EF of +8% (p < 0.001).”

“To shed light on this potential for recrudescent digitalis toxicity following release of bound digoxin , the author scrutinized the records of patients with impaired renal function who were treated with Digibind.”

“We are in the limit of the significance, for the connection between digoxinemia and the appearance of electrical signs of overdose in digitalis (p=0.06).”

“This has been further exacerbated by the recommendations of the Digitalis Investigation Group report [9] that have proposed a lower therapeutic range of 0.5 to 0.8 μg/L for digoxin.”

“In a 62-year-old male patient suffering from chronic digitalism , the serum digoxin level rose to 6.0 ng/ml.”

“ Digitalis intoxication is a common problem, mainly because of the narrow margin of safety of digoxin.”

“ Digitalis intoxication is a frequent iatrogenic effect in patients on treatment with digoxin.”

“These findings suggest the presence of … one substance sharing chemical properties with digitalis : (1) a substance …-reacting with digoxin antibodies and dependent on pulmonary vascular congestion; and (2) a substance capable of inhibiting the Na+-…+ pump and present in large amounts in heart diseases with a reduced cardiac index.”

“The current extensive use of digoxin in elderly patients with left ventricular failure and sinus rhythm may not be clinically justifiable; in a significant proportion of these patients the frequency of digitalis toxicity may outweigh the therapeutic benefits of the drug.”

“The degree of distribution of free digitalis and digitalis bound to proteins within the vascular system played an important role in the complex kinetics of digoxin.”