Key result
Coadministration of diltiazem increased mean trough digoxin concentrations from 1.11 ng/ml at baseline to 1.54 ng/ml after seven days (P<0.01) in patients with congestive heart failure.
Why the study?
Does diltiazem increase steady state digoxin serum levels in patients with congestive heart failure?
Does diltiazem increase steady state digoxin serum levels in patients with congestive heart failure?
Adding diltiazem to a digoxin regimen in heart failure patients significantly increases steady-state digoxin concentrations, highlighting a clinically relevant drug interaction.
Answers are grounded in this paper and cite their sources.
May warrant digoxin monitoring with diltiazem in heart failure; leaves open need for prospective validation.
Diltiazem has been reported to decrease or not to affect digoxin elimination. The effects of diltiazem on steady state concentrations of digoxin was evaluated in eleven patients with congestive heart failure receiving this drug for at least two weeks. The mean trough digoxin was 1.11 +/- 0.18 ng/ml before the coadministration of diltiazem (180 mg/day). This concentration increased to 1.54 +/- 0.22 ng/ml after three days and to 1.54 +/- 0.23 ng/ml after seven days of coadministration (P less than 0.01). Clinically, no patient showed signs of digitalis toxicity. Creatinine clearance was unchanged. The present results show that when diltiazem is added to a regimen that includes digoxin, steady state concentrations of this glycoside may increase.
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Andréjak et al. (1987) studied congestive heart failure (n=11). Diltiazem vs. Baseline (before coadministration) was evaluated on mean trough digoxin concentration (ng/ml) (p=<0.01). Coadministration of diltiazem increased mean trough digoxin concentrations from 1.11 ng/ml at baseline to 1.54 ng/ml after seven days (P<0.01) in patients with congestive heart failure.
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