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Drug Interactions between Digitek and maribavir

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

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Interactions between your drugs

Moderate

digoxin maribavir

Applies to: Digitek (digoxin) and maribavir

MONITOR: Coadministration of maribavir and digoxin may increase the plasma concentrations of digoxin. The proposed mechanism is decreased clearance of digoxin due to inhibition of P-glycoprotein (P-gp)-mediated drug efflux by maribavir. In a pharmacokinetic study, digoxin peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 25% and 21%, respectively, when digoxin (0.5 mg single dose) was concomitantly administered with maribavir (400 mg twice daily).

MANAGEMENT: Caution is advised when maribavir is used concurrently with digoxin. Clinical and laboratory monitoring as well as dosage adjustments may be appropriate for digoxin whenever maribavir is added to or withdrawn from therapy. Patients should be advised to notify their physician if they experience nausea, anorexia, visual disturbances, slow pulse, or irregular heartbeats.

References (1)
  1. (2021) "Product Information. Livtencity (maribavir)." Takeda Pharmaceuticals America

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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