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Erythrocin (as stearate)

Interactions

Digoxin, Oral/Macrolide Antibiotics

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Macrolides may increase the effects of digoxin.

What might happen:

The effects of your digoxin may increase and cause a slow or irregular heartbeat.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. The dose of your medicine may need adjusting. Let your doctor know if you have any nausea, vomiting, headaches, fatigue, drowsiness, weakness, disorientation, hallucinations, changes in vision, or a slow/irregular heartbeat.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

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2.Chan AL, Wang MT, Su CY, Tsai FH. Risk of digoxin intoxication caused by clarithromycin-digoxin interactions in heart failure patients: a population-based study. Eur J Clin Pharmacol 2009 Dec;65(12):1237-43.

3.Rengelshausen J, Goggelmann C, Burhenne J, Riedel KD, Ludwig J, Weiss J, Mikus G, Walter-Sack I, Haefeli WE. Contribution of increased oral bioavailability and reduced nonglomerular renal clearance of digoxin to the digoxin-clarithromycin interaction. Br J Clin Pharmacol 2003 Jul; 56(1):32-8.

4.Tanaka H, Matsumoto K, Ueno K, Kodama M, Yoneda K, Katayama Y, Miyatake K. Effect of clarithromycin on steady-state digoxin concentrations. Ann Pharmacother 2003 Feb;37(2):178-81.

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6.Tsutsumi K, Kotegawa T, Kuranari M, Otani Y, Morimoto T, Matsuki S, Nakano S. The effect of erythromycin and clarithromycin on the pharmacokinetics of intravenous digoxin in healthy volunteers. J Clin Pharmacol 2002 Oct; 42(10):1159-64.

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8.Ketek (telithromycin) US prescribing information. Sanofi-Aventis U.S. LLC December, 2010.

9.Thalhammer F, Hollenstein UM, Locker GJ, Janata K, Sunder-Plassmann G, Frass M, Burgmann H. Azithromycin-related toxic effects of digitoxin. Br J Clin Pharmacol 1998 Jan;45(1):91-2.

10.Hirata S, Izumi S, Furukubo T, Ota M, Fujita M, Yamakawa T, Hasegawa I, Ohtani H, Sawada Y. Interactions between clarithromycin and digoxin in patients with end-stage renal disease. Int J Clin Pharmacol Ther 2005 Jan;43(1):30-6.

11.Vergara-Lopez S, Garcia-Garcia JA, Merchante N, Mira JA. Digoxin toxicity secondary to inhibition of digoxin intestinal metabolism in a patient receiving clarithromycin. Med Clin (Barc) 2004 Nov 6;123(16):639.

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15.Wakasugi H, Yano I, Ito T, Hashida T, Futami T, Nohara R, Sasayama S, Inui K. Effect of clarithromycin on renal excretion of digoxin: interaction with P-glycoprotein. Clin Pharmacol Ther 1998 Jul; 64(1):123-8.

16.Nordt SP, Williams SR, Manoguerra AS, Clark RF. Clarithromycin induced digoxin toxicity. J Accid Emerg Med 1998 May;15(3):194-5.

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28.Norregaard-Hansen K, Klitgaard NA, Pedersen KE. The significance of the enterohepatic circulation on the metabolism of digoxin in patients with the ability of intestinal conversion of the drug. Acta Med Scand 1986; 220(1):89-92.

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30.Morton MR, Cooper JW. Erythromycin-induced digoxin toxicity. DICP 1989 Sep;23(9):668-70.

31.Cambonie G, Sabatier E, Guillaumont S, Masson F, Charbit J, Pidoux O, Hillaire-Buys D, Picaud JC. Digoxin-Josamycin: a dangerous drug interaction in children. Arch Pediatr 2006 Aug;13(8):1118-20.

32.Corallo CE, Rogers IR. Roxithromycin-induced digoxin toxicity. Med J Aust 1996 Oct 21;165(8):433-4.

33.Nenciu LM, Laberge P, Thirion DJ. Telithromycin-induced digoxin toxicity and electrocardiographic changes. Pharmacotherapy 2006 Jun;26(6):872-6.

34.Lanoxin (digoxin) Tablets US prescribing information. GlaxoSmithKline August, 2012.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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