No increase in serum digoxin concentration with high-dose diltiazem

The American Journal of Medicine
W E BodenR S Shulman

Abstract

The effect of incremental diltiazem dosing during concomitant digoxin administration over a four-week period in eight healthy adult volunteers (mean age, 28 +/- 4 years) was studied. The study group received 0.25 mg of digoxin twice daily for two days, after which they received 0.25 mg daily for the duration of the study. Following baseline electrocardiographic evaluation and measurement of trough digoxin levels, all subjects received 120 mg of diltiazem daily for one week, then 240 mg daily for one week, followed by 360 mg daily for one week. Resting electrocardiographic parameters (heart rate, P-R interval), renal function, electrolyte values, and digoxin and diltiazem concentrations were measured weekly. Daily administration of 360 mg of diltiazem plus 0.25 mg of digoxin resulted in a significant decrease in heart rate (from 68 +/- 9 beats per minute to 61 +/- 10 beats per minute; p less than 0.05), a marginal increase in P-R interval (from 169 +/- 22 msec to 179 +/- 21 msec; p = 0.08), and no significant change in trough serum digoxin concentration (from 0.85 +/- 0.08 ng/ml to 0.90 +/- 0.08 ng/ml; p = NS). The administration of up to 360 mg of diltiazem per day with 0.25 mg of digoxin per day was not associated with signifi...Continue Reading

References

May 15, 1984·The American Journal of Cardiology·Y OyamaK Goto
May 1, 1982·Circulation·H O KleinE Kaplinsky
Jan 1, 1982·European Journal of Clinical Pharmacology·K E PedersenK K Pedersen

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Citations

Jan 1, 1988·Cardiovascular Drugs and Therapy·J N Lessem
Jan 1, 1990·Pharmacology & Therapeutics·W KirchG G Belz
Dec 1, 1987·Journal of Clinical Pharmacology·M AndrejakJ P Lesbre

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