Digitoxin Elimination Reduced During Quinidine Therapy

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Abstract
Elevated serum digoxin concentrations and clinical toxicity were reported in patients receiving quinidine. A similar interaction between quinidine and another cardiac glycoside, digitoxin, was studied to evaluate the pharmacokinetic basis in 5 healthy volunteers. In the presence of quinidine serum digitoxin concentration was elevated, the mean digitoxin elimination half-life was increased from 87.8 .+-. 11.6 to 218.3 .+-. 20.6 h (mean .+-. standard error of the mean) (P < 0.01) and mean total body clearance was reduced from 5.01 .+-. 1.18 to 1.87 .+-. 0.20 ml/hour kg (P < 0.052). No change was observed in the apparent volume of distribution or in the volume of the central compartment for digitoxin. The mechanism for this interaction apparently is a reduction in elimination and not displacement of digitoxin from tissue binding sites.

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