title: A new enzyme-linked chemiluminescent immunosorbent digoxin assay is virtually free from interference of spironolactone, potassium canrenoate, and their common metabolite canrenone.
abstract: Spironolactone and potassium canrenoate (aldosterone antagonist diuretics) are sometimes used in conjunction with digoxin for patient management. Spironolactone, potassium canrenoate, and their common metabolite canrenone interfere with serum digoxin measurement using various immunoassays. Recently a new enzyme-linked chemiluminescent immunosorbent digoxin assay (ECLIA-Digoxin) became commercially available for application on the ADVIA IMS 800i modular system (Bayer HealthCare, Tarrytown, NY). We investigated the potential interference of spironolactone and related compounds in this assay by comparing the results with the fluorescence polarization immunoassay (FPIA), which is known to have significant cross-reactivity with these compounds as well as a turbidimetric assay for digoxin with no known cross-reactivity with spironolactone and related compounds. Aliquots of drug free serum were supplemented with therapeutic and above therapeutic concentrations of spironolactone, canrenone, and potassium canrenoate, and apparent digoxin concentrations were measured. No apparent digoxin concentration was observed using the ECLIA-Digoxin or turbidimetric assay. When serum pools prepared from patients receiving digoxin were further supplemented with these compounds, we observed no significant change in digoxin concentrations in the presence of these compounds with the ECLIA-Digoxin. We conclude that this assay is virtually free from interferences from spironolactone, potassium canrenoate and their common metabolite canrenone.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas-Houston Medical School, Houston, Texas 77030, USA. Amitava.Dasgupta@uth.tmc.edu
authors.forename: Amitava
authors.initials: A
authors.lastname: Dasgupta
authors.forename: Edward
authors.initials: E
authors.lastname: Kang
authors.forename: Pradip
authors.initials: P
authors.lastname: Datta
mesh_terms: D016477:Artifacts; D002192:Canrenone / Q000032:analysis* / Q000378:metabolism; D003429:Cross Reactions; D004077:Digoxin / Q000032:analysis / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D016231:Fluorescence Polarization Immunoassay; D006801:Humans; D008163:Luminescent Measurements / Q000379:methods*; D009391:Nephelometry and Turbidimetry; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D013148:Spironolactone / Q000032:analysis* / Q000378:metabolism
chemical_list: D011933:Reagent Kits, Diagnostic; D013148:Spironolactone; D004077:Digoxin; D002192:Canrenone