Wednesday November 1, 2006
Amiodarone - Digoxin interaction !


Q; How Amiodarone effects the level of Digoxin? (choose one)

A) It increases Digoxin level
B) It decreases Digoxin level
C) It can have unpredictable erratic effect
D) There is no interaction between these 2 drugs
E) It all depends on potassium level



Answer is (A)

Amiodarone increases the digoxin level. From ICU perspective it is important as it may happen within 24 hours of simultaneous administration and it may be appropriate to decrease the dose of digoxin.
Different mechanisms of this interaction is proposed but it is not entirely known. Proposed reasons include reduction in renal clearance of digoxin, displacement of digoxin from tissue-binding sites and altered GI absorption. Amiodarone is known to have spasmolytic effect on the smooth muscle of the intestine and may prolong the intestinal transit time of digoxin and thus the absorption of digoxin.


Related previous pearls:

Why we call it Am-iod-arone !!

Amiodarone Neurotoxicity !!