Drug General Information (ID: DDIKCPMS9A)
Drug Name			Digitoxin		Drug Info		Pasireotide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiarrhythmic Agents				Somatostatin/Somatostatin Analogs
Structure

Mechanism of Digitoxin-Pasireotide Interaction (Severity Level: Moderate)
Increased risk of atrioventricular block Click to Show/Hide Mechanism Graph
Drug Name		Digitoxin				Pasireotide
Mechanism 1		Delay atrioventricular conduction				Delay atrioventricular conduction
Key Mechanism Factor 1
		Factor Name		Atrioventricular block
		Factor Description		Atrioventricular block is a type of cardiac conduction block that occurs when the electrical signal from the atria to the ventricles is impaired. In an Atrioventricular block, this electrical signal is either delayed or completely blocked. When the signal is completely blocked, the ventricles produce their own electrical signal to control the heart rate. The heart rate produced by the ventricles is much slower than that produced by the sinus node.
Mechanism Description		Increased risk of atrioventricular block by the combination of Digitoxin and Pasireotide
Increased risk of bradycardia Click to Show/Hide Mechanism Graph
Drug Name		Digitoxin				Pasireotide
Mechanism 2		Bradycardia				Bradycardia
Key Mechanism Factor 2
		Factor Name		Bradycardia
		Factor Description		Bradycardia is a slow heart rate in which the heart beats less than 60 times per minute. If the heart rate is very slow and the heart is not pumping enough oxygen-rich blood to the body, and you may feel dizzy, very tired or weak, and short of breath.
Mechanism Description		Increased risk of bradycardia by the combination of Digitoxin and Pasireotide

Recommended Action
Management		Pasireotide has not been studied in patients receiving other bradycardic drugs. Because bradycardia and AV block are recognized risk factors for torsade de pointes arrhythmia, electrocardiographic monitoring is recommended prior to initiation of pasireotide and during treatment. Dose adjustments of beta blockers and calcium channel blockers or correction of electrolyte disturbances may be necessary.

References
1	Canadian Pharmacists Association.
2	Cerner Multum, Inc. "Australian Product Information.".
3	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
4	Product Information. Exelon (rivastigmine) Novartis Pharmaceuticals, East Hanover, NJ.
5	Product Information. Signifor (pasireotide). Novartis Pharmaceuticals, East Hanover, NJ.