Effect of Quinidine on Digoxin Concentration in Skeletal Muscle and Serum in Patients with Atrial Fibrillation

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Abstract
QUINIDINE causes a rise in serum steady-state concentrations of digoxin1 2 3 4 5 and reduces both renal and nonrenal clearances of digoxin.6 7 8 A redistribution of digoxin from tissue stores was suggested as a second underlying mechanism when it was shown that quinidine also increased serum digoxin levels when digoxin maintenance therapy was discontinued before quinidine treatment was started.4 , 5 In further studies, a quinidine-induced 30 to 40 per cent reduction in the apparent volume of distribution of digoxin was found.7 , 8 About 50 per cent of the body's load of digoxin is located in skeletal muscle.9 We investigated whether a redistribution of digoxin from skeletal . . .