Drug General Information (ID: DDIXRSHIN9)
Drug Name			Sodium bicarbonate		Drug Info		Digitoxin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antidiarrheals				Antiarrhythmic Agents
Structure

Mechanism of Sodium bicarbonate-Digitoxin Interaction (Severity Level: Minor)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Sodium bicarbonate				Digitoxin
Mechanism		Polyvalent cations				Binds to polyvalent cations
Key Mechanism Factor 1
		Factor Name		Chelation
		Factor Description		Chelation is a direct drug interaction that usually involves the formation of dimers or trimers, resulting in larger complexes and poorer absorption.
Mechanism Description		Decreased absorption of Sodium bicarbonate due to formation of complexes caused by Digitoxin

References
1	Allen MD, Greenblatt DJ, Harmatz JS, Smith TW "Effect of magnesium--aluminum hydroxide and kaolin--pectin on absorption of digoxin from tablets and capsules." J Clin Pharmacol 21 (1981): 26-30. [PMID: 7012189]
2	Bonelli J, Hruby K, Magometschnigg D, Hitzenberger G, Kaik G "The bio-availability of beta-acetyldigoxine alone and combined with aluminum hydroxide and magnesium hydroxide (Alucol)." Int J Clin Pharmacol Biopharm 15 (1977): 337-9. [PMID: 892951]
3	Brown DD, Juhl RP "Decreased bioavailability of digoxin due to antacids and kaolin-pectin." N Engl J Med 295 (1976): 1034-7. [PMID: 972657]
4	D'Arcy PF, McElnay JC "Drug-antacid interactions: assessment of clinical importance." Drug Intell Clin Pharm 21 (1987): 607-17. [PMID: 2886325]
5	Marcus FI "Pharmacokinetic interactions between digoxin and other drugs." J Am Coll Cardiol 5 (1985): a82-90. [PMID: 2985676]
6	McElnay JC, Harron DW, D'Arcy PF, Eagle MR "Interaction of digoxin with antacid constituents." Br Med J 1 (1978): 1554. [PMID: 656806]
7	Product Information. Suprep Bowel Prep Kit (magnesium/potassium/sodium sulfates). Braintree Laboratories, Braintree, MA.
8	Rodin SM, Johnson BF "Pharmacokinetic interactions with digoxin." Clin Pharmacokinet 15 (1988): 227-44. [PMID: 3056649]
9	Liu F, Qiu M, Zhai SD. Tolerability and effectiveness of (S)-amlodipine compared with racemic amlodipine in hypertension: a systematic review and meta-analysis.?Curr Ther Res Clin Exp. 2010;71(1):1-29. [PMID: 24683248]