The effect of quinidine and other oral antiarrhythmic drugs on serum digoxin. A prospective study.

Abstract:

:We compared the effects of quinidine and three alternate antiarrhythmic drugs on serum digoxin concentration in 63 patients before and during administration of quinidine, procainamide, disopyramide, or mexiletine. Quinidine increased digoxin concentration by at least 0.5 nmol/L in 21 of 22 patients: Mean serum digoxin rose from 1.2 nmol/L to 2.4 nmol/L (P less than 0.001). Procainamide, disopyramide, or mexiletine increased serum digoxin by 0.5 nmol/L in one of 41 patients. Anorexia, nausea, and vomiting develop soon after starting quinidine therapy in 10 of the 22 patients who received quinidine but in only five of the 41 patients who received procainamide, disopyramide, or mexiletine (P less than 0.01). Quinidine prolonged the PR intervals from 160 +/- 14 ms to 183 +/- 26 ms, but procainamide, disopyramide, and mexiletine did not change the PR interval (P less than 0.005). In digitalized patients, quinidine increases serum digoxin concentration, increases digoxin's effect on atrioventricular conduction, and produces more adverse gastrointestinal effects than procainamide, disopyramide, or mexiletine.

journal_name

Ann Intern Med

authors

Leahey EB Jr,Reiffel JA,Giardina EG,Bigger JT Jr

doi

10.7326/0003-4819-92-5-605

subject

Has Abstract

pub_date

1980-05-01 00:00:00

pages

605-8

issue

5

eissn

0003-4819

issn

1539-3704

journal_volume

92

pub_type

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