Moracizine Digoxin

MORACIZINE CARDIAC GLYCOSIDES -DIGOXIN Case reports of heart block when moracizine is co-administered with digoxin Uncertain at present Monitor PR and ECG closely... 

Digoxin does not interact with a variety of antidysrhjdhmic drugs, including ajmaline, aprindine, lidocaine, lidoflazine (225), and moracizine (226). Other drugs that may have minor and clinically unimportant interactions include cap-topril, carvedilol, disopyramide, and flosequinan. 

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. ... 

Moracizine does not significantly increase serum digoxin levels in patients with normal renal function. However, some adverse conduction effects have been seen. 

No changes in the pharmacokinetics of digoxin were seen in a singledose study of intravenous digoxin and moracizine in 9 healthy subjects or in a study in patients receiving maintenance treatment with digoxin over a 13-day period. However, cardiac arrhythmias (AV junctional rhythm and heart block) were seen, which resolved when the moracizine was stopped. ... 

Not established. There does not appear to be a pharmacokinetic interaction between moracizine and digoxin. Concurrent use can cause a significant increase in the PR interval and QRS duration, which can result in AV block. ... 

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