Gastrointestinal tract digoxin

The gastrointestinal tract is the main site of action of acarbose, which is metabolized exclusively within the gastrointestinal tract, principally by intestinal bacteria this process may be adversely affected by antibiotics that alter the intestinal bacterial flora. Acarbose affects the absorption of some drugs (e.g. digoxin). 

The interaction between macrohdes and digoxin is not a consequence of altered cytochrome P450 activity. Digoxin is metabolized in the gastrointestinal tract by Eubacterium lentum in the bowel flora of about 10% of patients (106). The direct antibacterial effect of macrohdes reduces digoxin metabolism and increases its systemic availabihty (134). The resultant increased digoxin plasma concentrations are associated with severe nausea, vomiting, and dysrhythmias (105,145,146). 

Binds digoxin in gastrointestinal tract and reduces absorption by 25%... 

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