Drug Interactions between digoxin and Senokot Direct Relief
This report displays the potential drug interactions for the following 2 drugs:
- digoxin
- Senokot Direct Relief (glycerin)
Interactions between your drugs
digoxin glycerin
Applies to: digoxin and Senokot Direct Relief (glycerin)
MONITOR: Although diuretics and digitalis glycosides are frequently and appropriately used together, diuretic-induced hypokalemia and hypomagnesemia may predispose patients on digitalis to arrhythmias.
MANAGEMENT: Digoxin, potassium and magnesium levels should be followed closely. Hypokalemia and hypomagnesemia should be treated appropriately. Digitalis dose adjustments may be required. Patients should be advised to notify their physicians if they experience signs of possible digoxin toxicity or electrolyte disturbances, such as weakness, lethargy, muscle pains or cramps, nausea, anorexia, visual disturbances, or irregular heartbeats.
References
- Tilstone WJ, Semple PF, Lawson DH, Boyle JA (1977) "Effects of furosemide on glomerular filtration rate and clearance of practolol, digoxin, cephaloridine, and gentamicin." Clin Pharmacol Ther, 22, p. 389-94
- Semple P, Tilstone WJ, Lawson DH (1975) "Furosemide and urinary digoxin clearance." N Engl J Med, 293, p. 612-3
- Brown DD, Dormois JC, Abraham GN, et al. (1976) "Effect of furosemide on the renal excretion of digoxin." Clin Pharmacol Ther, 20, p. 395-400
- McAllister RG, Howell SM, Gomer MS, Selby JB (1976) "Effect of intravenous furosemide on the renal excretion of digoxin." J Clin Pharmacol, 16, p. 110-7
- Malcolm AD, Leung FY, Fuchs JC, Duarte JE (1977) "Digoxin kinetics during furosemide administration." Clin Pharmacol Ther, 21, p. 567-74
- Waldorff S, Hansen PB, Kjaergard H, Buch J, Egeblad H, Steiness E (1981) "Amiloride-induced changes in digoxin dynamics and kinetics: abolition of digoxin-induced inotropism with amiloride." Clin Pharmacol Ther, 30, p. 172-6
- Macolic V, Vrhovac B (1993) "Pharmacokinetics and interactions of digoxin, theophylline and furosemide in diseases with edema." Int J Clin Pharmacol Ther Toxicol, 31, p. 6-11
- Whang R, Oei TO, Watanabe A (1985) "Frequency of hypomagnesemia in hospitalized patients receiving digitalis." Arch Intern Med, 145, p. 655-6
- Cohen L, Kitzes R (1983) "Magnesium Sulfate and digitalis-toxic arrhythmias." JAMA, 249, p. 2808-10
- Leary WP, Reyes AJ (1984) "Drug interactions with diuretics." S Afr Med J, 65, p. 455-61
Drug and food interactions
digoxin food
Applies to: 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
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
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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