lanoxicaps and Cordarone i v Interactions

Interactions between lanoxicaps(digoxin) and Cordarone i v (amiodarone)

amiodarone and digoxin (Major Drug-Drug)

ADJUST DOSE: Coadministration with amiodarone may increase serum digoxin concentrations by up to 100%, frequently resulting in clinical toxicity. In children, this percentage may be even higher. Amiodarone has been suggested to increase intestinal transit time, reduce renal clearance and volume of distribution, displace digoxin from protein binding sites, as well as induce hypothyroidism, all of which may contribute to increased serum digoxin levels. In addition, both drugs may have additive bradycardic effects. Torsade de pointes cardiac arrhythmia has been reported. The interaction also has occurred with digitoxin.

MANAGEMENT: The need for continued digitalis therapy should be evaluated if amiodarone is prescribed to patients treated with digitalis. Empirical reduction of digitalis dosage by one-third to one-half should be considered in patients who require concomitant treatment with these drugs. Serum digitalis levels should be closely monitored and patients observed for clinical evidence of toxicity. Patients should be advised to seek medical attention if they experience signs of digitalis toxicity such as nausea, anorexia, visual disturbances, slow pulse, or irregular heartbeats.