Digoxin with Epoprostenol Interaction Details
Brand Names Associated with Digoxin
- Cardoxin®
- Digitek®
- Digoxin
- Lanoxicaps®
- Lanoxin®
Brand Names Associated with Epoprostenol
- Epoprostenol
- Flolan®
- Veletri®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jan 08, 2024
Interaction Effect
Increased digoxin plasma concentrations
Interaction Summary
Concomitant use of digoxin and epoprostenol may result in elevated digoxin plasma concentrations due to a decrease in the oral clearance of digoxin. Increased digoxin exposure following epoprostenol initiation may be clinically significant in patients who are susceptible to digoxin toxicity. Monitoring the patient for increased digoxin side effects and toxicity may be warranted.
Severity
Moderate
Onset
Delayed
Evidence
Established
How To Manage Interaction
Concomitant use of digoxin and epoprostenol has resulted in increased digoxin plasma concentrations, which may be clinically significant in patients predisposed to digoxin toxicity. When used concomitantly, monitor patients closely for signs/symptoms of digoxin toxicity, including nausea, vomiting, and arrhythmias.
Mechanism Of Interaction
Reduced oral clearance of digoxin
Literature Reports
A) In a pharmacokinetics substudy, the digoxin oral clearance value decreased in patients (n=30) who were receiving digoxin for congestive heart failure when epoprostenol treatment was initiated. On day two of concomitant epoprostenol therapy, the apparent oral clearance value for digoxin was reduced by 15%; however, by day 87 of concomitant therapy, it had returned to baseline .
Digoxin Overview
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Digoxin is used to treat heart failure and abnormal heart rhythms (arrhythmias). It helps the heart work better and it helps control your heart rate.
Epoprostenol Overview
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Epoprostenol injection is used to treat certain kinds of pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Epoprostenol may improve the ability to exercise and slow the worsening of symptoms in patients with PAH. Epoprostenol is in a class of medications called vasodilators and platelet-aggregation inhibitors. It works by relaxing the blood vessels, including those in the lungs, and improving blood flow.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.