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Drug Interactions between Digitek and epoprostenol

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Minor

digoxin epoprostenol

Applies to: Digitek (digoxin) and epoprostenol

Epoprostenol may decrease clearance of oral digoxin. The mechanism has not been determined. Theoretically, this interaction could lead to higher digoxin plasma concentrations and could potentiate toxicity. One pilot study noted a 15% decrease in clearance (which was statistically significant) on day 3 of administration. However, this change was not apparent by day 87. The change in digoxin clearance would not be expected to be clinically significant, except possibly in patients with higher baseline digoxin levels. Epoprostenol and digoxin have been used safely together during epoprostenol clinical trials.

References (1)
  1. Carlton LD, Patterson JH, Mattson CN, Schmith VD (1996) "The effects of epoprostenol on drug disposition. 1: a pilot study of the pharmacokinetics of digoxin with and without epoprostenol in patients with congestive heart failure." J Clin Pharmacol, 36, p. 247-56

Drug and food interactions

Minor

digoxin food

Applies to: Digitek (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 (2)
  1. Darcy PF (1995) "Nutrient-drug interactions." Adverse Drug React Toxicol Rev, 14, p. 233-54
  2. 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

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.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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