Key result
Chronic administration of perindopril did not significantly alter steady-state 24-hour digoxin area under the curve (16.3 vs 17.9 ng/mL.h) in patients with mild chronic heart failure.
Why the study?
Does perindopril alter digoxin pharmacokinetics in patients with mild chronic heart failure?
Does perindopril alter digoxin pharmacokinetics in patients with mild chronic heart failure?
Co-prescription of perindopril does not alter steady-state digoxin kinetics in patients with mild chronic heart failure and normal renal function, indicating no digoxin dose adaptation is required.
Answers are grounded in this paper and cite their sources.
Supports no digoxin dose adjustment with perindopril in mild HF; leaves open effects in renal impairment or severe disease.
The influence of chronic perindopril treatment on digoxin pharmacokinetics was investigated in 10 patients with mild chronic heart failure under stable diuretic and digitalis treatment and normal renal function. Digoxin was administered at a dose of 0.125 mg/day (n = 2) or 0.250 mg/day (n = 8). The 24-hour steady-state digoxin profile was assessed before and after concomitant administration of perindopril for 1 month at doses of 2 mg once a day for the first 8 days and 4 mg once a day for the remaining 21 days. Chronic treatment with perindopril produced no significant effect on mean (+/- standard deviation) digoxin serum area under the curve for 24 hours (17.9 +/- 7.4 versus 16.3 +/- 4.4 ng/mL.h), peak digoxin concentration (1.3 +/- 0.54 versus 1.2 +/- 0.36 ng/mL), time to peak concentration (3 versus 4 hours), and apparent oral clearance of digoxin (237.7 +/- 109.6 versus 237.4 +/- 79.5 mL/min). Clinical and biologic tolerance of perindopril was good throughout the study. Chronic administration of perindopril did not alter steady-state digoxin kinetics in patients with mild chronic heart failure and normal renal function, indicating that no adaptation of the digoxin dose is required during co-prescription with perindopril in such patients.
No takes yet. Share an insight, caveat, or question.
Vandenburg et al. (1993) studied mild chronic heart failure (n=10). Perindopril vs. Baseline (before perindopril administration) was evaluated on 24-hour steady-state digoxin serum area under the curve. Chronic administration of perindopril did not significantly alter steady-state 24-hour digoxin area under the curve (16.3 vs 17.9 ng/mL.h) in patients with mild chronic heart failure.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: