On the interaction between phenytoin and digoxin.
An open, randomized, single-blind cross over trial to investigate phenytoin-digoxin interactions at steady state was performed in 6 healthy male volunteers. Coadministration of phenytoin caused a significant reduction in the elimination half-life of digoxin from 33.9 to 23.7 h and a diminution in AUC0-48 from 31.6 to 24.4 ng X ml-1 X h. Renal digoxin clearance was not significantly altered from 135.7 to 120.3 ml X min-1. Assuming no change in beta-acetyldigoxin absorption, the in decrease time-course the serum digoxin concentration was due to a significantly increased total digoxin clearance from 258.6 to 328.3 ml X min-1. An insignificant reduction in the digoxin distribution volume from 749.4 to 668.0 l was also observed. No relevant change in the pharmacokinetic parameters (elimination half-life, area under the serum concentration time-curve, protein binding) of phenytoin was observed when phenytoin and digoxin were co-administered. The data suggest that with this drug combination the serum digoxin concentration should be carefully monitored and, if necessary, the daily digoxin dose should be increased.
D000328:Adult; D004077:Digoxin / Q000378:metabolism* / Q000494:pharmacology; D004347:Drug Interactions; D006801:Humans; D008297:Male; D008657:Metabolic Clearance Rate / Q000187:drug effects; D010672:Phenytoin / Q000097:blood / Q000494:pharmacology*
D010672:Phenytoin; D004077:Digoxin