Influence of Spironolactone on Serum Digoxin Concentration
- Joseph A. Paladino, PharmD;
- Kenneth H. Davidson, MD, FACC
- Bruce B. McCall, PharmD
Since this article does not have an abstract, we have provided the first 150 words of the full text.
Excerpt
To the Editor.— We wish to call attention to the interaction of spironolactone with digoxin. Previously reported in specialty journals, this information is rarely found in the general medical literature. We report a case that illustrates likely interaction.
Report of a Case. — An 81-year-old woman with multiple medical problems, including chronically elevated results of liver function tests and congestive heart failure, was admitted to the hospital for treatment of gastrointestinal tract bleeding. Bibasalar rales were evident on lung examination, and a chest roentgenogram disclosed bilateral pleural effusions. An electrocardiogram demonstrated a normal sinus rhythm; her pulse rate was 92 beats per minute.
She had been compliant on her medication regimen, which included digoxin and spironolactone. Digoxin was withheld on admission and use of spironolactone was discontinued soon after. The admission serum digoxin concentration (SDC), drawn approximately 12 hours after the last dose, was reported as 2.4 ng/mL. The patient
