Cisapride Digoxin

Drugs that affect nefazodone include general anesthetics, sibutramine, sumatriptan, buspirone, carbamazepine, and propranolol. Drugs that may be affected by nefazodone include alcohol, benzodiazepines, buspirone, carbamazepine, cisapride, digoxin, haloperidol, HMG-CoA reductase inhibitors, MAOIs, propranolol, St. John s wort, cyclosporine, and tacrolimus. 

Drugs that may be affected by telithromycin include cisapride, digoxin, ergot alkaloids, metoprolol, midazolam, pimozide, HMG-CoA reductase inhibitors, sotalol, and theophylline. 

Drugs that may affect disopyramide include antiarrhythmics, beta blockers, cisapride, clarithromycin, erythromycin, fluoroquinolones, hydantoins, quinidine, thioridazine, rifampin, verapamil, and ziprasidone. Drugs that may be affected by disopyramide include quinidine, anticoagulants, and digoxin. 

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 be affected by SSRIs Drugs that may be affected by SSRIs include alcohol, benzodiazepines, beta blockers, buspirone, carbamazepine, cisapride, clozapine, cyclosporine, diltiazem, digoxin, haloperidol, hydantoins, lithium, methadone, mexiletine, nonsedating antihistamines, NSAIDs, olanzapine, phenothiazines, phenytoin, pimozide, procyclidine, ritonavir, ropivacaine, sumatriptan, sulfonylureas, sympathomimetics, tacrine, theophylline, tolbutamide, tricyclic antidepressants, and warfarin. 

Clarithromycin Drugs that may be affected by clarithromycin include anticoagulants, benzodiazepines, buspirone, carbamazepine, cisapride, cyclosporine, digoxin. 

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. 

GFJ has been shown to increase the exposure of carbamazepine (175), cisapride (176-179), fluvoxamine (184), losartan (188), methadone (189), scopolamine (191), and sertraline (192). However, only the interaction of GFJ with carbamazepine and cisapride seems to be clinically relevant. No alteration in exposure was observed for clozapine (180,181), heophylline (195), halo-peridol (196), and omeprazole (190). Reports of increased pharmacokinetic parameters of clozapine, theophylline, and haloperidol suggest that an interaction is unlikely to be clinically relevant. Contradicting results were reported for itraconazole (185-187), digoxin (75,183), and sildenafil (193,194). An increased effect on concomitant use of diclofenac and GFJ was observed in rats (182). Overall, the clinical relevance for this drug class appears to be low. 

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... 

Absorption interactions involving altered gastrointestinal motility have been described. These include interactions of digoxin with propantheline (204), meto-clopramide (204), and cisapride (205). However, the chnical relevance of these interactions is unclear and they are probably unimportant. 

Kirch W, Janisch HD, Santos SR, Duhrsen U, Dylewicz P, Ohnhaus EE. Effect of cisapride and metoclopramide on digoxin bioavailability. Eur J Drug Metab Pharmacokinet 1986 ll(4) 249-50. 

Kubler PA, Pillans PI, McKay JR. Possible interaction between cisapride and digoxin. Ann Pharmacother 2001 35(l) 127-8. 

A possible interaction between cisapride and digoxin has been reported (31). 

The authors speculated that cisapride reduced digoxin absorption by accelerating bowel transit time. 

Clinically important, potentially hazardous interactions with alfentanil, aminophylline, amisulpride, amoxicillin, ampicillin, anticonvulsants, astemizole, atorvastatin, benzodiazepines, bromocriptine, buprenorphine, bupropion, carbamazepine, cilostazol, ciprofloxacin, cisapride, clindamycin, colchicine, cyclosporine, dasatinib, digoxin, dihydroergotamine, diltiazem, disopyramide, enoxacin, eplerenone, ergotamine, eszopiclone, everolimus, fluconazole, fluoxetine, fluvastatin, gatifloxacin, HMG-CoA reductase inhibitors, imatinib, itraconazole, ketoconazole, lomefloxacin, lorazepam, lovastatin, methadone, methylprednisolone, methysergide, midazolam, mizolastine, moxifloxacin, nitrazepam, norfloxacin, ofloxacin, paroxetine, pimozide, pravastatin, quinolones, ranolazine, repaglinide, rupatadine, sertraline, sildenafil, simvastatin, sparfloxacin, sulpiride, tacrolimus, terfenadine, triazolam, troleandomycin, vardenafil, verapamil, vinblastine, warfarin, zaleplon, zolpidem, zuclopenthixol... 

Clinically important, potentially hazardous interactions with atorvastatin, carbamazepine, cisapride, cyclosporine, digoxin, dihydroergotamine, ergotamine, fesoterodine, hexobarbital, ixabepilone, lapatinib, lovastatin, metoprolol, midazolam, nilotinib, phenobarbital, phenytoin, pimozide, rifampin, rimonabant, simvastatin, sirolimus, tacrolimus, temsirolimus, tolvaptan, triazolam, warfarin... 

Transporter efflux transporter effects predominant Examples Amiodarone Atorvastatin Azithromycin Carbamazepine Carvediioi Chlorpromazine Ciprofloxacin Cisapride Cyciosporine Danazoi Dapsone Diclofenac Diflunisal Digoxin Erythromycin Flurbiprofen Glipizide Glyburide Griseofulvin Ibuprofen Indinavir Indomethacin Itraconazole Ketoconazole Lansoprazole Lovastatin Mebendazole Naproxen Nelfinavir Ofloxacin Oxaprozin Phenazopyridine Phenytoin Piroxicam Raloxifene Ritonavir Saquinavir Saquinavir Sirolimus Sirolimus Spironolactone Spironolactone Tacrolimus Tacrolimus ... 

Telithromycin has several clinically significant drug interactions similar to those for erythromycin. It is both a substrate and a strong inhibitor of CYP3A4. Coadministration of rifampin, a potent inducer of CYP, decreases the serum concentrations of telithromycin by 80%. CYP3A4 inhibitors (e.g., itraconazole) increase peak serum concentrations of telithromycin. Serum concentrations of CYP3A4 substrates (e.g., pimozide, cisapride, midazolam, statins, cyclosporine, phenytoin) are increased by telithromycin. Telithromycin also increases peak serum concentrations of metoprolol and digoxin. 

Noninterfering acetaminophen, N-acetylprocainamide, amikacin, amitriptyline, amlodi-pine, carbamazepine, cefotaxime, ceftazidime, chloramphenicol, ciprofloxacin, cisapride, clindamycin, clonidine, codeine, cyclosporine, digoxin, diphenhydramine, disopyramide, ethosuximide, fluconazole, gentamicin, gentamicin, heparin, labetalol, levothyroxine, li-docaine, lithium, methotrexate, metronidazole, minoxidil, nafcillin, nifedipine, phenobar-bital, phenobarbital, phenytoin, phenytoin, primidone, procainamide, propranolol, quini-dine, ranitidine, salicylic acid, theophylline, tobramycin, tobramycin, valproic acid, warfarin... 

Caution is recommended when eplerenone is used with alpha blockers, antipsychotics, amifostine, baclofen, corticosteroids, tetracosactide and tricyclic antidepressants. Lithium, ciclosporin, and tacrolimus should generally not be used with eplerenone. Antacids, cisapride, midazolam and simvastatin had no effect on eplerenone pharmacokinetics. Eplerenone had no important effect on cisapride, midazolam, warfarin or contraceptive steroid pharmacokinetics, but caused a slight increase in digoxin levels. 

The manufacturers of sirolimus note that cisapride and metoclo-pramide may increase sirolimus levels, although there do not appear to be any published reports of this interaction. No significant pharmacokinetic interaction has been found with aci-clovir, digoxin, glibenclamide or co-trimoxazole. There is an isolated case report of atorvastatin increasing sirolimus trough serum levels twofold in one patient, and a reduction in the sirolimus dose was required. ... 

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