Drug Interactions between Cardoxin and cimetidine
This report displays the potential drug interactions for the following 2 drugs:
- Cardoxin (digoxin)
- cimetidine
Interactions between your drugs
cimetidine digoxin
Applies to: cimetidine and Cardoxin (digoxin)
Both increases and decreases in serum digoxin concentrations have been reported following the administration of cimetidine. Other studies have failed to document any changes in digoxin pharmacokinetics during concomitant therapy. The clinical significance of this interaction has yet to be elucidated. Cimetidine may interact with digitoxin in a similar manner.
References
- Baciewicz AM, Baciewicz FA (1989) "Effect of cimetidine and ranitidine on cardiovascular drugs." Am Heart J, 118, p. 144-54
- Fraley DS, Britton HL, Schwinghammer TL, Kalla R (1983) "Effect of cimetidine on steady-state serum digoxin concentrations." Clin Pharm, 2, p. 163-5
- Garty M, Perry G, Shmueli H, et al. (1986) "Effect of cimetidine on digoxin disposition in peptic ulcer patients." Eur J Clin Pharmacol, 30, p. 489-91
- Mouser B, Nykamp D, Murphy JE, Krissman PH (1990) "Effect of cimetidine on oral digoxin absorption." DICP, 24, p. 286-8
- Crome P, Curl B, Holt D, Volans GN, Bennett PN, Cole DS (1985) "Digoxin and cimetidine: investigation of the potential for a drug interaction." Hum Toxicol, 4, p. 391-9
Drug and food interactions
digoxin food
Applies to: Cardoxin (digoxin)
Administration of digoxin with a high-fiber meal has been shown to decrease its bioavailability by almost 20%. Fiber can sequester up to 45% of the drug when given orally. Patients should be advised to maintain a regular diet without significant fluctuation in fiber intake while digoxin is being titrated.
Grapefruit juice may modestly increase the plasma concentrations of digoxin. The mechanism is increased absorption of digoxin due to mild inhibition of intestinal P-glycoprotein by certain compounds present in grapefruits. In 12 healthy volunteers, administration of grapefruit juice with and 30 minutes before, as well as 3.5, 7.5, and 11.5 hours after a single digoxin dose (0.5 mg) increased the mean area under the plasma concentration-time curve (AUC) of digoxin by just 9% compared to administration with water. Moreover, P-glycoprotein genetic polymorphism does not appear to influence the magnitude of the effects of grapefruit juice on digoxin. Thus, the interaction is unlikely to be of clinical significance.
References
- Darcy PF (1995) "Nutrient-drug interactions." Adverse Drug React Toxicol Rev, 14, p. 233-54
- Becquemont L, Verstuyft C, Kerb R, et al. (2001) "Effect of grapefruit juice on digoxin pharmacokinetics in humans." Clin Pharmacol Ther, 70, p. 311-6
cimetidine food
Applies to: cimetidine
Concurrent use of cimetidine and ethanol may result in increased ethanol concentrations. The mechanism appears to be due to inhibition of gastric alcohol dehydrogenase by cimetidine, leading to increased bioavailability of the alcohol and inhibition of hepatic metabolism of alcohol. The clinical significance of this interaction is limited. More importantly, patients requiring cimetidine for gastrointestinal disease should be counseled to avoid alcohol to prevent worsening of their disease. The other H-2 receptor antagonists appear to have minimal effects on the concentrations of alcohol.
References
- Feely J, Wood AJ (1982) "Effects of cimetidine on the elimination and actions of ethanol." JAMA, 247, p. 2819-21
- Hansten PD (1992) "Effects of H2-receptor antagonists on blood alcohol levels." JAMA, 267, p. 2469
cimetidine food
Applies to: cimetidine
Caffeine effects may be increased in patients also taking cimetidine. The mechanism may be due to decreased caffeine metabolism induced by cimetidine. Although adequate clinical data are lacking, a reduction in dose or elimination of caffeine may be needed if excess CNS stimulation is observed.
References
- (2001) "Product Information. Tagamet (cimetidine)." SmithKline Beecham
- Broughton LJ, Rodgers HJ (1981) "Decreased systenuc clearance of caffeine due to cimetidine." Br J Clin Pharmacol, 12, p. 155-9
cimetidine food
Applies to: cimetidine
H2 antagonists may reduce the clearance of nicotine. Cimetidine, 600 mg given twice a day for two days, reduced clearance of an intravenous nicotine dose by 30%. Ranitidine, 300 mg given twice a day for two days, reduced clearance by 10%. The clinical significance of this interaction is not known. Patients should be monitored for increased nicotine effects when using the patches or gum for smoking cessation and dosage adjustments should be made as appropriate.
References
- Bendayan R, Sullivan JT, Shaw C, Frecker RC, Sellers EM (1990) "Effect of cimetidine and ranitidine on the hepatic and renal elimination of nicotine in humans." Eur J Clin Pharmacol, 38, p. 165-9
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Report options
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
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