Skip to main content
PMC home page
British Journal of Clinical Pharmacology logoLink to British Journal of Clinical Pharmacology
. 1981 Feb;11(2):181–186. doi: 10.1111/j.1365-2125.1981.tb01122.x

Pharmacokinetics of digoxin in patients subjected to the quinidine-digoxin interaction.

K Schenck-Gustafsson, R Dahlqvist
PMCID: PMC1401574  PMID: 7213521

Abstract

1 This study was designed to evaluate pharmacokinetically the digoxin-quinidine interaction in patients with atrial fibrillation. 2 Five patients on maintenance digoxin therapy were given [3H]-digoxin as a single i.v. dose before and during quinidine therapy and the elimination of [3H]-digoxin from plasma and excretion in urine were determined. 3 The mean steady state plasma concentration of digoxin increased from 0.7 to 1.3 nmol/l after quinidine administration. 4 The apparent volume of distribution of digoxin decreased on the average 38%. Renal clearance and the total body clearance of digoxin decreased 51 and 56% respectively (mean values). Also non renal clearance was reduced. The fraction of digoxin excreted unmetabolised in urine did not change during quinidine treatment. The mean elimination half life of digoxin increased from 49 to 72 h during quinidine. 5 In two patients the DC-shock did not cause a conversion to sinus rhythm. However, the quinidine induced changes in the pharmacokinetics of digoxin in these patients did not differ from the others. 6 Quinidine appears to decrease the amount of digoxin distributed to body tissue(s). In addition, the reduction of renal clearance of digoxin and the observed unchanged clearance of creatinine suggests an inhibition of the renal secretion of digoxin.

Full text

PDF
186

Selected References

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

  1. Bartels H., Böhmer M., Heierli C. Serum Kreatinibestimmung ohne Enteiweissen. Clin Chim Acta. 1972 Mar;37:193–197. doi: 10.1016/0009-8981(72)90432-9. [DOI] [PubMed] [Google Scholar]
  2. Björkhem I., Blomstrand R., Ohman G. Mass fragmentography of creatinine proposed as a reference method. Clin Chem. 1977 Nov;23(11):2114–2121. [PubMed] [Google Scholar]
  3. CRAMER G., ISAKSSON B. QUANTITATIVE DETERMINATION OF QUINIDINE IN PLASMA. Scand J Clin Lab Invest. 1963;15:553–556. doi: 10.1080/00365516309079786. [DOI] [PubMed] [Google Scholar]
  4. Collste P., Nordlander R. Quinidine dosage, with special reference to an oral loading dose schedule. Br J Clin Pharmacol. 1979 Mar;7(3):293–297. doi: 10.1111/j.1365-2125.1979.tb00935.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dahlqvist R., Ejvinsson G., Schenck-Gustafsson K. Effect of quinidine on plasma concentration and renal clearance of digoxin. A clinically important drug interaction. Br J Clin Pharmacol. 1980 Apr;9(4):413–418. doi: 10.1111/j.1365-2125.1980.tb01070.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Doering W., König E. Anstieg der Digoxinkonzentration im Serum unter Chinidinmedikation. Med Klin. 1978 Jul 28;73(30):1085–1088. [PubMed] [Google Scholar]
  7. Ejvinsson G. Effect of quinidine on plasma concentrations of digoxin. Br Med J. 1978 Feb 4;1(6108):279–280. doi: 10.1136/bmj.1.6108.279. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Erni F., Frei R. W. A comparison of reversed-phase and partition high-performance liquid chromatography of some digitalis glycosides. J Chromatogr. 1977 Jan 11;130:169–180. doi: 10.1016/s0021-9673(00)89793-9. [DOI] [PubMed] [Google Scholar]
  9. Hager W. D., Fenster P., Mayersohn M., Perrier D., Graves P., Marcus F. I., Goldman S. Digoxin-quinidine interaction Pharmacokinetic evaluation. N Engl J Med. 1979 May 31;300(22):1238–1241. doi: 10.1056/NEJM197905313002202. [DOI] [PubMed] [Google Scholar]
  10. Hooymans P. M., Merkus F. W. Effect of quinidine on plasma concentration of digoxin. Br Med J. 1978 Oct 7;2(6143):1022–1022. doi: 10.1136/bmj.2.6143.1022-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kramer W. G., Lewis R. P., Cobb T. C., Forester W. F., Jr, Visconti J. A., Wanke L. A., Boxenbaum H. G., Reuning R. H. Pharmacokinetics of digoxin: comparison of a two- and a three-compartment model in man. J Pharmacokinet Biopharm. 1974 Aug;2(4):299–312. doi: 10.1007/BF01061404. [DOI] [PubMed] [Google Scholar]
  12. Leahey E. B., Jr, Reiffel J. A., Drusin R. E., Heissenbuttel R. H., Lovejoy W. P., Bigger J. T., Jr Interaction between quinidine and digoxin. JAMA. 1978 Aug 11;240(6):533–534. [PubMed] [Google Scholar]
  13. Waldorff S., Andersen J. D., Heebøll-Nielsen N., Nielsen O. G., Moltke E., Sørensen U., Steiness E. Spironolactone-induced changes in digoxin kinetics. Clin Pharmacol Ther. 1978 Aug;24(2):162–167. doi: 10.1002/cpt1978242162. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Clinical Pharmacology are provided here courtesy of British Pharmacological Society

RESOURCES