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. 1991 Jan;31(1):108–110. doi: 10.1111/j.1365-2125.1991.tb03867.x

Interaction between digoxin and indomethacin or ibuprofen.

H S Jørgensen 1, H R Christensen 1, J P Kampmann 1
PMCID: PMC1368422  PMID: 2015162

Abstract

To study a potential interaction between digoxin and two non-steroid anti-inflammatory drugs, indomethacin (50 mg three times daily) and ibuprofen (600 mg three times daily) were given for 10 days to 10 and 8 patients, respectively, on chronic digoxin treatment. Serum digoxin measured by fluorescence polarisation immunoassay increased significantly (P less than 0.05) during treatment with indomethacin from pre-treatment values of 0.73 +/- 0.34 nmol l-1 (mean +/- s.d.) to a mean value of 1.02 +/- 0.43 nmol l-1, while administration of ibuprofen did not change the steady state serum concentration of digoxin. The result demonstrates that some non-steroidal anti-inflammatory drugs such as indomethacin increase serum digoxin to levels high in the therapeutic range. This should be taken into consideration when co-administering other drugs known to increase the serum concentration of digoxin such as several antiarrhythmics.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Clark D. R., Inloes R. L., Kalman S. M., Sussman H. H. Abbott TDx, Dade Stratus, and Du Pont aca automated digoxin immunoassays compared with a reference radioimmunoassay method. Clin Chem. 1986 Feb;32(2):381–385. [PubMed] [Google Scholar]
  2. Doering W., Isbary J. Der Einfluss von Tiaprofensäure auf die Digoxin-Konzentration im Serum. Arzneimittelforschung. 1983;33(1):167–168. [PubMed] [Google Scholar]
  3. Edner M. Serum digoxin concentration: increase after rest in different body positions. J Cardiovasc Pharmacol. 1990 Mar;15(3):508–509. [PubMed] [Google Scholar]
  4. Fenster P. E., Comess K. A., Hanson C. D., Finley P. R. Kinetics of the digoxin-aspirin combination. Clin Pharmacol Ther. 1982 Oct;32(4):428–430. doi: 10.1038/clpt.1982.184. [DOI] [PubMed] [Google Scholar]
  5. Finch M. B., Johnston G. D., Kelly J. G., McDevitt D. G. Pharmacokinetics of digoxin alone and in the presence of indomethacin therapy. Br J Clin Pharmacol. 1984 Mar;17(3):353–355. doi: 10.1111/j.1365-2125.1984.tb02353.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Koren G. Clinical pharmacokinetic significance of the renal tubular secretion of digoxin. Clin Pharmacokinet. 1987 Nov;13(5):334–343. doi: 10.2165/00003088-198713050-00004. [DOI] [PubMed] [Google Scholar]
  7. Koren G., Zarfin Y., Perlman M., MacLeod S. M. Effects of indomethacin on digoxin pharmacokinetics in preterm infants. Pediatr Pharmacol (New York) 1984;4(1):25–30. [PubMed] [Google Scholar]
  8. Quattrocchi F. P., Robinson J. D., Curry R. W., Jr, Grieco M. L., Schulman S. G. The effect of ibuprofen on serum digoxin concentrations. Drug Intell Clin Pharm. 1983 Apr;17(4):286–288. doi: 10.1177/106002808301700411. [DOI] [PubMed] [Google Scholar]
  9. Schimmel M. S., Inwood R. J., Eidelman A. I., Eylath U. Toxic digitalis levels associated with indomethacin therapy in a neonate. Clin Pediatr (Phila) 1980 Nov;19(11):768–769. doi: 10.1177/000992288001901111. [DOI] [PubMed] [Google Scholar]
  10. Zöller B., Engel H. J., Faust-Tinnefeldt G., Geissler H. E., Gilfrich H. J., Zimmer M. An interaction study between benoxaprofen and digoxin. Eur J Rheumatol Inflamm. 1982;5(2):82–86. [PubMed] [Google Scholar]
  11. Zöller B., Engel H. J., Faust-Tinnefeldt G., Gilfrich H. J., Zimmer M. Untersuchungen zur Wechselwirkung von Isoxicam und Digoxin. Z Rheumatol. 1984 Jul-Aug;43(4):182–184. [PubMed] [Google Scholar]

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