Effect of furosemide on the renal excretion of digoxin

Brown, Donald J.; Dormois, John C.; Abraham, George N.; Lewis, Kathleen; Dixon, Keith

doi:10.1002/cpt1976204395

Cited by 30 publications

(4 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Both increases and decreases of digoxin renal excretion were reported after administration of relatively high doses of furosemide. Other groups reported the absence of relevant effects of furosemide on digoxin pharmacokinetics . In the current cocktail trial, digoxin CL R was not increased in cocktail T3, suggesting an extrarenal site of interaction.…”

Section: Discussioncontrasting

confidence: 45%

Pharmacokinetic Evaluation of a Drug Transporter Cocktail Consisting of Digoxin, Furosemide, Metformin, and Rosuvastatin

Stopfer

Gießmann

Hohl

et al. 2016

Clin Pharma and Therapeutics

View full text Add to dashboard Cite

This article reports the clinical investigation of a probe drug cocktail containing substrates of key drug transporters. Single oral doses of 0.25 mg digoxin (P‐gp), 5 mg furosemide (OAT1 and OAT3), 500 mg metformin (OCT2, MATE1, and MATE2‐K), and 10 mg rosuvastatin (OATP1B1, OATP1B3, and BCRP) were administered separately or as a cocktail in a randomized six‐period crossover trial in 24 healthy male volunteers. As a cocktail, relative bioavailabilities of digoxin and metformin and furosemide AUC0‐tz were similar to separate dosing. However, when administered as a cocktail the Cmax of furosemide was 19.1% lower and the Cmax and AUC0‐tz of rosuvastatin were 38.6% and 43.4% higher, respectively. In addition, the effects of increased doses of metformin or furosemide on the cocktail were investigated in 11 and 12 subjects, respectively. The cocktail explored in this trial has the potential to be used for the in vivo screening of transporter‐mediated drug–drug interactions. © 2016 American Society for Clinical Pharmacology and Therapeutics

show abstract

Section: Discussioncontrasting

confidence: 45%

Pharmacokinetic Evaluation of a Drug Transporter Cocktail Consisting of Digoxin, Furosemide, Metformin, and Rosuvastatin

Stopfer

Gießmann

Hohl

et al. 2016

Clin Pharma and Therapeutics

View full text Add to dashboard Cite

show abstract

“…How ever, serum digoxin levels, renal digoxin clearance, urinary digoxin excretion and the ratio of urine creatinine to urine digoxin con centration have been reported to be unaf fected by furosemide administration [28]. In agreement with these findings, we found no significant increase in urinary EOLS excre tion in furosemide-treated neonates.…”

Section: Discussionsupporting

confidence: 82%

Urinary Excretion of Endogenous Ouabain-Like Substance in Furosemide-Treated Neonates: Its Relation to Renal Excretory Pattern and Endocrine Factors

Sulyok¹,

Adamovits

Worgall

et al. 1997

Neonatology

View full text Add to dashboard Cite

The present study was undertaken to define the possible role of endogenous ouabain-like substance (EOLS) in controlling renal excretory pattern, in mediating the renal responses to furosemide and in inducing endocrine reactions in furosemide-treated neonates. Ten newborn infants with mean birthweight of 2,752 g and mean gestational age of 37.1 weeks were given furosemide in a dose of 1 mg/kg. Prior to and following furosemide therapy, urine was collected for a period of 12 h and analyzed for creatinine, osmolality, sodium and potassium, as well as for EOLS, arginine vasopressin (AVP), aldosterone and endothelin-1 (ET-1). In response to furosemide administration, urine flow rate and urinary osmolar, sodium and potassium excretion increased significantly, whereas creatinine excretion remained unchanged. Furthermore, following furosemide therapy, urinary excretion of EOLS (148.7 ± 70.8 vs. 200.1 ± 98.1 pg/kg/h) and AVP (19.5 ± 5.4 vs. 27.8 ± 7.8 pg/kg/h) tended to increase, whereas ET-1 (36.0 ± 5.6 vs. 61.4 ± 8.7fmol/kg/h, p < 0.01) and aldosterone (507 ± 120 vs. 751 ± 203 ng/kg/h, p < 0.05) increased significantly. Prior to furosemide, urinary EOLS excretion was found to correlate positively with diuresis (r = 0.80, p < 0.01), sodium (r = 0.91, p < 0.001), creatinine (r = 0.75, p < 0.001), osmolar (r = 0.96, p < 0.001), ET-1 (r = 0.90, p < 0.001) and AVP (r = 0.92, p < 0.001) excretion. After furosemide, urinary EOLS excretion significantly correlated only with diuresis (r = 0.69, p < 0.05), ET-1 (r = 0.77, p < 0.01) and AVP (r = 0.92, p < 0.001). Urinary EOLS proved to be independent of aldosterone excretion irrespective of furosemide administration. It is concluded that urinary EOLS excretion is closely related to neonatal renal excretory pattern and it may have a role in controlling diuresis and natriuresis. The renal response to furosemide appears to be independent of EOLS, although interdependent endocrine reactions can be induced by furosemide which may modulate the production rate and urinary excretion of EOLS.

show abstract

“…BARROS and CHRISTIANNE B.V. SCARAMELLO is important to note that this pharmacodynamic interaction does not change Cp values of digoxin (Brown et al 1976) although may precipitate or contribute to arrhythmias development, especially in patients with preexisting cardiac anomalies. These effects can be prevented by dietary sodium restriction or addition of potassium sparing diuretics (Moura et al 2009).…”

mentioning

confidence: 99%

Study of digoxin use in a public health unit

Souza

Marques

Scaramello³

et al. 2015

An. Acad. Bras. Ciênc.

View full text Add to dashboard Cite

Digoxin is used for heart failure associated to systolic dysfunction and high ventricular rate. It has a narrow therapeutic range and intoxication may occur due to drug interactions or comorbidities. The aim of this work was to study digoxin use in a public health unit delineating the profile of patients susceptible to digitalis intoxication. Medical records belonging to patients admitted to the cardiomyopathy ward of the health unit (2009)(2010) and in use of digoxin were analyzed. Among 647 patients admitted, 185 individuals using digoxin and possessed records available. The registration of plasma digoxin concentration was found in 80 records and it was out of the therapeutic range in 42 patients (52.5%). This group of individuals was constituted mainly by males patients (79%), functional class III of heart failure (65%), exhibiting renal failure (33%). The evaluated sample reflects the epidemiology of heart failure in Brazil and, although pharmacotherapy had been according to Brazilian Guidelines, apparently the monitoring was not performed as recommended. This work highlighs the necessity of plasma digoxin constant monitoring during pharmacotherapy and the development of protocols that enable a safer use, especially in male patients, functional class III and with renal dysfunction.

show abstract

Effect of furosemide on the renal excretion of digoxin

Cited by 30 publications

References 4 publications

Pharmacokinetic Evaluation of a Drug Transporter Cocktail Consisting of Digoxin, Furosemide, Metformin, and Rosuvastatin

Pharmacokinetic Evaluation of a Drug Transporter Cocktail Consisting of Digoxin, Furosemide, Metformin, and Rosuvastatin

Urinary Excretion of Endogenous Ouabain-Like Substance in Furosemide-Treated Neonates: Its Relation to Renal Excretory Pattern and Endocrine Factors

Study of digoxin use in a public health unit

Contact Info

Product

Resources

About