Details of Drug Interaction

Details of Drug-Drug Interaction

 Drug General Information (ID: DDI4ZS7A5L)
  Drug Name Digoxin Drug Info Halazepam Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Antiarrhythmic Agents Antianxiety Agents
  Structure

 Mechanism of Digoxin-Halazepam Interaction (Severity Level: Moderate)
     Competitive binding of plasma proteins Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Digoxin Halazepam
      Mechanism Competition for plasma protein binding sites Competition for plasma protein binding sites
      Key Mechanism Factor 1
Factor Name Plasma protein binding
Factor Description Plasma protein binding refers to the degree of binding of a drug to proteins in the blood, and the lower the degree of binding, the more efficiently the drug can cross cell membranes or diffuse. Plasma protein binding alters the distribution and therapeutic characteristics of the drugs.
      Mechanism Description
  • Increased plasma concentration of Halazepam and Digoxin due to competitive binding of plasma proteins

Recommended Action
      Management Close observation for clinical and laboratory evidence of digoxin toxicity is recommended if these drugs must be used together. Patients should be advised to notify their physician if they experience nausea, anorexia, visual disturbances, slow pulse, or irregular heartbeats.

References
1 Castillo-Ferrando JR, Garcia M, Carmona J "Digoxin levels and diazepam." Lancet 2 (1980): 368. [PMID: 6105500]
2 Castillo-Ferrando JR, Prieto AC, Brasas F "Effects of benzodiazepines on digoxin tissue concentrations and plasma protein binding." J Pharm Pharmacol 35 (1983): 462-3. [PMID: 6136591]
3 Guven H, Tuncok Y, Guneri S, Cavdar C, Fowler J "Age-related digoxin-alprazolam interaction." Clin Pharmacol Ther 54 (1993): 42-4. [PMID: 8330464]
4 Ochs HR, Greenblatt DJ, Verburg-Ochs B "Effect of alprazolam on digoxin kinetics and creatinine clearance." Clin Pharmacol Ther 38 (1985): 595-8. [PMID: 2865030]
5 Rodin SM, Johnson BF "Pharmacokinetic interactions with digoxin." Clin Pharmacokinet 15 (1988): 227-44. [PMID: 3056649]
6 Tollefson G, Lesar T, Grothe D, Garvey M "Alprazolam-related digoxin toxicity." Am J Psychiatry 141 (1984): 1612-3. [PMID: 6150651]
7 Tollefson G, Lesar T, Grothe D, Garvey M "Alprazolam-related digoxin toxicity." Am J Psychiatry 141 (1984): 1612-4. [PMID: 6150651]