Journal article
Effects of hypocholesterolemic interventions on digoxin bioavailability
Drug metabolism reviews, Vol.9(1), pp.107-117
1979
PMID: 446263
Abstract
Cholestyramine, meals high in dietary fiber content, and PAS produce clinically significant interference with absorption of oral digoxin. Cholestyramine's effect is dose related and is most marked when it is administered simultaneously with digoxin. Its interference can be minimized by temporal separation of the time of cholestyramine administration from that of the glycoside. This can be readily accomplished by using cholestyramine in a twice daily dosage schedule, which has been demonstrated to be equally as effective as a four-times-a-day dose regimen in terms of cholesterol reduction. There is a distinct variation in the response of any given individual to the effect of cholestyramine, both in the degree and the type of response. The mechanism of the interference is presumed to be related to physical binding of digoxin to cholestyramine, as has been demonstrated in vitro in other laboratories. Greenblatt et al. previously demonstrated that meals per se do not reduce oral digoxin absorption. Therefore, physical adsorption is proposed as the mechanism for the interference with digoxin oral absorption by meals with a high fiber content, since dietary fiber is similar to cholestyramine in its binding characteristics. The marked reduction in the D-xylose absorption associated with PAS therapy in our patients suggests an alteration in gut wall absorption. Since digoxin is absorbed by a passive, nonsaturable transport process similar to that of D-xylose, such an alteration of intestinal function would seem to be a reasonable mechanism for the alteration in digoxin's absorption produced by PAS. Such alterations in intestinal absorptive function are reminiscent of those previously found with neomycin, which has also been found to alter the absorption of digoxin.
Details
- Title: Subtitle
- Effects of hypocholesterolemic interventions on digoxin bioavailability
- Creators
- D D BrownR P JuhlS L Warner
- Resource Type
- Journal article
- Publication Details
- Drug metabolism reviews, Vol.9(1), pp.107-117
- PMID
- 446263
- ISSN
- 0360-2532
- eISSN
- 1097-9883
- Language
- English
- Date published
- 1979
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984094629102771
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