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Drug Interactions between Digitek and pasireotide

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

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Interactions between your drugs

Moderate

digoxin pasireotide

Applies to: Digitek (digoxin) and pasireotide

MONITOR: The risk of significant bradycardia and atrioventricular (AV) block may be increased during concomitant treatment of pasireotide with other drugs that slow heart rate or AV conduction such as beta-blockers, calcium channel blockers, atazanavir, digitalis, flecainide, lacosamide, mefloquine, moricizine, and propafenone.

MANAGEMENT: Pasireotide has not been studied in patients receiving other bradycardic drugs. Because bradycardia and AV block are recognized risk factors for torsade de pointes arrhythmia, electrocardiographic monitoring is recommended prior to initiation of pasireotide and during treatment. Dose adjustments of beta blockers and calcium channel blockers or correction of electrolyte disturbances may be necessary.

References (5)
  1. (2001) "Product Information. Exelon (rivastigmine)." Novartis Pharmaceuticals
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
  4. Cerner Multum, Inc. "Australian Product Information."
  5. (2013) "Product Information. Signifor (pasireotide)." Novartis Pharmaceuticals

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.

See also

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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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