Effect of furosemide on the renal excretion of digoxin

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Abstract
Digoxin serum and urine levels were determined by radioimmunoassay in 6 subjects (4 patients with heart disease and 2 volunteers without heart disease) who had been maintained on oral digoxin (0.25 or 0.5 mg daily). Observations were made during a 3-day control period and then during 8 days of concomitant digoxin and oral furosemide (40 mg daily) therapy. Serum digoxin levels determined 10 and 24 hr after each dose of digoxin averaged 1.2 ± 0.1 ng/ml (M ± SE) during control and 1.3 ± 0.1 during the last 3 days on digoxin and furosemide. The daily urinary excretion of digoxin averaged 51 ± 6% of the oral dose during control and 52 ± 6 during the entire period of furosemide administration. The renal clearance of digoxin and creatinine averaged 94 ± 7 and 87 ± 11 ml/min, respectively, during control; corresponding values were 88 ± 8 and 85 ± 9 for urine collections demonstrating a distinct diuretic effect of furosemide and 87 ± 8 and 75 ± 10 for urine collections not demonstrating such an effect during diuretic therapy. The results suggest that the diuretic effect of furosemide does not significantly affect the excretion of digoxin.

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