Esmolol-Digoxin Drug Interaction

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Abstract
An open‐label baseline‐controlled study was conducted in 11 healthy male subjects to study the possible interaction between the cardioselective, short‐acting beta blocker esmolol and digoxin when administered concurrently under steady‐state conditions. Steady‐state concentration, elimination half‐life, and the total body clearance of esmolol were not changed significantly (P > .05) by digoxin. Digoxin peak concentration and the time to reach the peak concentration were not affected by esmolol. However, the digoxin AUC during the six‐hour esmolol infusion increased from 2.60 ± 0.59 to 2.88 ± 0.75 ng ṁ hr/mL (P < .05). There were no clinically significant changes in the heart rate and blood pressure during this drug interaction study. The PR intervals were similar between digoxin monotherapy and esmolol plus digoxin combined treatment. Although digoxin did not influence the kinetics of esmolol, the small increase seen in digoxin serum concentration during the combination therapy warrants that caution be exercised during concurrent administration of esmolol and digoxin to patients.

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