Digoxin Amiodarone

Caution with haloperidol, amiodarone, digoxin, octreotide Increased risk of hypotension, bradycardia, and cardiac conduction abnormalities... 

Clinically important, potentially hazardous interactions with aminophylline, amiodarone, digoxin, prednisolone... 

Numerous drugs ((1-blockers, diltiazem, verapamil, digoxin, and amiodarone) can cause bradyarrhythmias (sinus bradycardia and AV nodal blockade). 

Adenosine 3-Blockers Amiodarone Carbamazepine Chloroquine Digoxin Diltiazem Gatifloxacin... 

Ventricular Rate Control is achieved by inhibiting the proportion of electrical impulses conducted from the atria to the ventricles through the AV node. Therefore, drugs that are effective for ventricular rate control are those that inhibit AV nodal impulse conduction P-blockers, diltiazem, verapamil, and digoxin (Tables 6-5 and 6-6). Amiodarone also inhibits AV nodal conduction, but is not a preferred drug for ventricular rate control in AF due to its unfavorable adverse-effect profile (Table 6-6). 

Digoxin Inhibits AV nodal conduction by 1. Vagal stimulation 2. Directly slowing AV nodal conduction and prolonging AV nodal refractoriness 0.25 mg every 2 hours up to 1.5 mg 0.125-0.25 mg PO once daily Amiodarone, verapamil, quinidine inhibit digoxin elimination... 

Amiodarone 5-7 mg/kg IV over 30-60 minutes 700-1200 mg over 24 hours Inhibits elimination of digoxin and warfarin... 

Maintenance dose 0.125-0.25 mg PO/IV qd low potassium or magnesium levels potentiate toxicity reduce dose in renal failure toxicity indicated by nausea, headache, visual disturbances (yellow-green halos), ventricular arrhythmias. Quinidine, verapamil, and amiodarone elevate digoxin level. 

Drugs that may affect flecainide include amiodarone, cimetidine, cisapride, disopyramide, propranolol, ritonavir, urinary acidifiers/alkalinizers, and verapamil. Smoking may also have an effect. Drugs that may be affected by flecainide include cisapride, propranolol, and digoxin. 

Drugs that may affect amiodarone include hydantoins, cholestyramine, fluoroquinolones, rifamycins, ritonavir, and cimetidine. Drugs that may be affected by amiodarone include anticoagulants, beta-blockers, calcium channel blockers, cyclosporine, dextromethorphan, digoxin, disopyramide, fentanyl, flecainide, hydantoins, lidocaine, methotrexate, procainamide, quinidine, and theophylline. Drug/Lab test interactions Amiodarone alters the results of thyroid function tests, causing an increase in serum T4 and serum reverse T3 levels and a decline in... 

Cardiovascular Acetyldigosin, ajmaline, amiodarone, aprindine, bepridil, bezaflbrate, captopril, dinepazide, clopidogrel, coumarins, diazoxide, digoxin, dipyridamole, disopyramide, doxazosin, enalapril, flurbiprofen, fur-oxemide, hydralazine, lisinopril methyldopa, metolazone, nifedipine, phenindione, procainamide, propanolol, propafenone, quinidine, ramapril, spironolactone, thiazide diuretics, ticlopidine, vesnarinone... 

Amiodarone increases the hypoprothrombinemic response to warfarin (an oral anticoagulant) by reducing its metabolism. Patients receiving digoxin may undergo an increase in serum digoxin concentrations when amiodarone is added to the treatment regimen. Amiodarone interferes with hepatic and renal elimination of flecainide, phenytoin, and quinidine. 

Quinidine inhibits the tubular secretion of digoxin which consequently raises the plasma digoxin concentration, which may be associated with toxicity. Certain other drugs also increase the digoxin concentration like verapamil, amiodarone, spironolactone etc. 

Digoxin Amiodarone, quinidine, quinine Potentiation may occur. 

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