Digoxin Alprazolam

Drugs that may be affected by itraconazole include alfentanil, almotriptan, alprazolam, amphotericin B, aripiprazole, benzodiazepines, buspirone, busulfan, calcium blockers, carbamazepine, cilostazol, cisapride, corticosteroids, cyclosporine, digoxin, disopyramide, docetaxel, dofetilide, eletriptan, epierenone, ergot alkaloids, haloperidol, HMG-CoA reductase inhibitors, hydantoins (phenytoin), hypoglycemic agents, oral midazolam, phosphodiesterase type 5 inhibitors, pimozide, polyenes, protease inhibitors, quinidine, rifamycins, sirolimus, tacrolimus, tolterodine, triazolam, trimetrexate, vinca alkaloids, warfarin, and zolpidem. 

St. John s wort Alprazolam, cyclosporine, digoxin, indinavir, oral contraceptives, ritonavir, simvastatin, tacrolimus, warfarin... 

Itraconazole Alfentanil, alprazolam, astemizole, atorvastatin, buspirone, cisapride, cyclosporine, delavirdine, diazepam, digoxin, felodipine, indinavir, loratadine, lovastatin, midazolam, nisoldipine, phenytoin, quinidine, ritonavir, saquinavir, sildenafil, simvastatin, sirolimus, tacrolimus, triazolam, verapamil, warfarin... 

DIGOXIN ANXIOLYTICS AND HYPNOTICS Alprazolam and possibly diazepam may t digoxin levels, particularly in the over-65s Uncertain at present Monitor digoxin levels watch for digoxin toxicity... 

Clinically important, potentially hazardous interactions with alprazolam, aprepitant, astemizole, atorvastatin, benzodiazepines, carbamazepine, chlordiazepoxide, cilostazol, clonazepam, clorazepate, colchicine, conivaptan, cyclosporine, dabigatran, dasatinib, diazepam, digoxin, dihydroergotamine, disopyramide, ergot alkaloids, fesoterodine, fluoxetine, flurazepam, fluvastatin, HMG-CoA reductase inhibitors, imatinib, ixabepilone, lapatinib, lopinavir, lorazepam, lovastatin, methylprednisolone, methysergide, midazolam, nilotinib, oxazepam, paroxetine, pimozide, pravastatin, prednisone, quazepam, repaglinide, rimonabant, rivaroxaban, sertraline, silodosin, simvastatin, solifenacin, temazepam, temsirolimus, tolvaptan, trabectedin, triazolam, warfarin, zidovudine... 

Arold G, Donath F, Maurer A, DiefenbachK, Bauer S, Henneicke-von Zepelin H-H, Friede M, Roots I. No relevant interaction with alprazolam, caffeine, tolbutamide, and digoxin by treatment with a low-h3fperforin St John s wort extract. Planta Med (2005) 71,331-7. 

Digoxin toxicity occurred in two elderly patients and rises in serum digoxin levels have been seen in others when they were given alprazolam. A reduction in the urinary clearance of digoxin has been described during the use of diazepam. No pharmacokinetic interaction seems to occur with digoxin and eszopiclone, zaleplon, or Zolpidem. 

Uncertain. The suggestion is that diazepam may possibly alter the extent of the protein binding of digoxin within the plasma, which may have some influence on the renal tubular excretion, but see eomments on protein binding interactions in Drug distribution interactions , (p.3). The reason for the interaction between digoxin and alprazolam is not understood. 

Tollefson G, Lesar T, Grothe D, Garvey M. Alprazolam-ielated digoxin toxicity. AmJPsydd-atry 9ZA) A, 6 2- A. 

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