Captopril Digoxin

Drugs associated with clinically useful or physiologically important positive inotropic effects include all of the following EXCEPT (A) Amrinone Captopril Digoxin Dobutamine Norepinephrine... 

Drugs that may be affected by antacids include allopurinol, amphetamines, benzodiazepines, captopril, chloroquine, corticosteroids, dicumarol, diflunisal, digoxin, ethambutol, flecainide, fluoroquinolones, histamine H2 antagonists,... 

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... 

Examples of specific drugs used in the treatment of chronic heart failure include digitalis glycosides (e.g., digoxin, positive inotropic agent), diuretics (hydrochlortiazide and furosemide), and vasodilators (nitrates such as nitroglycerin, ACE inhibitors, such as captopril, and hydralazine). 

ACE INHIBITORS DIGOXIN t plasma concentrations of digoxin when captopril is co-administered in the presence of heart failure (class II or more severe) or renal insufficiency. No other ACE inhibitors seem to interact in the same way Uncertain postulated to be due to 1 renal excretion of digoxin Monitor digoxin levels watch for digoxin toxicity... 

Enalapril, paracetamol, sotalol, dipyrone, vancomycin, captopril, fluconazole, cefazolin, metoprolol, aspirin, ticlopidine, prednisolone, propranolol, digoxin, sildenafil, furosemide, dexamethasone, carvedilol, ketoprofen, nifedipine, terbinafine, acenocoumarol, spironolactone/urine HPLC DAD Column LiChroCART Purospher STAR, RP-18e (250 x 4 mm, 5 pm) Mobile phase MeOH ACN 0.05 % TFA in water (gradient elution) Detection DAD X = 200 50 nm Adjusted to pH 7.0, protein precipitation LOD 0.01-1.44 pg/mL LOQ 0.04-4.35 pg/mL [72]... 

Cleland JG, Dargie HJ, Pettigrew A, Gillen G, Robertson JL The effects of captopril on serum digoxin and urinary urea and digoxin clearances in patients with congestive heart failure. Am Heart J 1986 112(l) 130-5. 

Magelli C, Bassein L, Ribani MA, Liberatore S, Ambrosioni E, Magnani B. Lack of effect of captopril on serum digoxin in congestive heart failure. Eur J Clin Pharmacol 1989 36(1) 99-100. 

Miyakawa T, Shionoiri H, Takasaki I, Kobayashi K, Ishii M. The effect of captopril on pharmacokinetics of digoxin in patients with mild congestive heart failure. J Cardiovasc Pharmacol 1991 17(4) 576-80. 

Kirimli O, Kalkan S, Guneri S, Tuncok Y, Akdeniz B, Ozdamar M, Guven H. The effects of captopril on serum digoxin levels in patients with severe congestive heart failure. Int J Clin Pharmacol Ther 2001 39(7) 311-14. 

Medications whose excretion is primarily renal and for which there is evidence of age-related reduction in renal and total body clearance include (but are not limited to) amantadine, aminoglycosides, atenolol, captopril, cimetidine, digoxin, lithium, and vancomycin. Some hepatically metabolized medications can yield active, primarily renally excreted metabolites such as iV-acetylprocainamide, normeperidine, and morphine-6-glucuronide, which can accumulate with advancing age owing to reduced renal function. 

Noninterfering albuterol, allopurinol, alprenolol, aspirin, atenolol, captopril, carbimazole, clonidine, coloxyl, danthron, diazepam, digoxin, doxepin, glibenclamide, hydralazine, in-domethacin, labetalol, metformin, methyldopa, metoprolol, mianserin, minoxidil, nifedipine, nitrazepam, oxazepam, oxprenolol, pindolol, prazosin, propranolol, senokot, theophylline, trifluoperazine... 

Noninterfering amiloride, acebutolol, acenocoumarol, acetaminophen, aspirin, allopuri-nol, ambroxol, amoxicillin, atenolol, bendroflumethiazide, benzbromarone, bezafibrate, biperiden, bisacodyl, bromazepam, butizide, captopril, cimetidine, ciprofloxacin, clobu-tinol, clonidine, cotinine, diazepam, diclofenac, digitoxin, digoxin, dihydrocodeine, dihy-droergotamine, diltiazem, doxepin, doxycycline, enalapril, erythromycin, fenoterol, furosemide, glibenclamide, heparin, h3qjoxanthine, ibuprofen, indomethacin, isosorbide... 

Another report describes a man taking warfarin, digoxin, captopril and furosemide with an INR of about 3, who developed chest pain and breathlessness about 2 weeks after starting to take Danshen. He was found to have a massive pleural effusion, which was later drained of blood, and an USTR of more than 8.4. He was later discharged on his usual dose of warfarin with an INR stable at 3, in the absence of the Danshen ... 

However, in one case report the prothrombin time of a woman taking warfarin, digoxin, captopril and prednisone rose from a range of 15 to 20 seconds up to 41 seconds within 4 days of starting moracizine 300 mg three times daily. She bled (haematemesis, haematuria), but responded rapidly to withdrawal of the warfarin and moracizine, and the administration of phytomenadione. ... 

Most ACE inhibitors do not interact with digoxin to a clinically relevant extent. Some studies have found that serum digoxin levels rise by about 20% or more if captopril is used, but others have found no significant changes. It has been su ested that any interaction is likely to occur only in those patients who have pre-existing renal impairment. Digitoxin and captopril appear not to interact. 

Cleland JGF, Daigie HJ, Hodanan GP, Robeits( i JIS, Ball SG. Interaction of digoxin and captopril. BrJCZmPhfl/TOOcoZ(1984) 17,214P. 

Rossi GP, Semplicini A, Boi ovi S, Mozzato MG, Paleari CD, Pessina AC. Effect of acute captopril administration cn digoxin pharmacokinetics in normal subjects. Curr Ther Res (1989) 46,439. ... 

Case three was a 62-year-old man also taking digoxin, captopril, and furosemide (Izzat et al. 1998). The man had consumed a decoction of Chinese salvia daily for 2 weeks prior to hospital admission for a massive pleural effusion and large pericardial effusion. 

---