Coadministration of digoxin with itraconazole in renal transplant recipients.
Digoxin toxicity is a major public health issue in the United States. Often this is due to drug interactions, and renal transplant recipients are at particularly high risk for drug-drug interactions. We present cases of 2 renal transplant recipients who received itraconazole and digoxin concomitantly and experienced digoxin toxicity. We have also reviewed the relevant literature to elicit the mechanisms, signs, and symptoms of digoxin toxicity in the presence of itraconazole. When clinicians know the potential drug-drug interactions that may lead to digoxin toxicity, the mechanisms of interaction, the signs and symptoms of digoxin toxicity, and appropriate monitoring, digoxin toxicity is largely preventable.
Mathis
A S
AS
Department of Pharmacy Practice and Administration, College of Pharmacy, Rutgers, The State University of New Jersey, College of Pharmacy, Piscataway, NJ, USA. smathis@sbhcs.com
Friedman
G S
GS
D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy; D004077:Digoxin / Q000009:adverse effects* / Q000627:therapeutic use; D004347:Drug Interactions; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017964:Itraconazole / Q000494:pharmacology / Q000627:therapeutic use*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016559:Tacrolimus / Q000627:therapeutic use
D000889:Anti-Arrhythmia Agents; D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D017964:Itraconazole; D004077:Digoxin; D016559:Tacrolimus