Why the study?
Does concomitant clarithromycin treatment alter digoxin pharmacokinetics in elderly patients chronically taking digoxin?
Does concomitant clarithromycin treatment alter digoxin pharmacokinetics in elderly patients chronically taking digoxin?
Concomitant use of clarithromycin significantly increases digoxin concentrations and half-life in elderly patients, highlighting a clinically important pharmacokinetic interaction.
May warrant avoiding or monitoring clarithromycin in elderly digoxin users; leaves open prospective confirmation of clinical outcomes.
The study was a prospective observational trial carried out to assess the clarithromycin-digoxin interaction in elderly patients chronically taking digoxin. Digoxin concentrations were determined before and after concomitant treatment with clarithromycin. A Bayesian approach was used to calculate digoxin pharmacokinetics. In the seven patients who were studied there was a significant increase in digoxin concentration after 4-7 days of clarithromycin treatment; digoxin clearance and elimination rate constant were 56-60% lower and elimination half-life was 82% longer. The pharmacokinetic clarithromycin-digoxin interaction in the elderly may be much more frequent than has been assumed up to now.
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Pedro Zapater (2002) studied this question.
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