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I have a question to our forum members:
Is there any published report that suggests clinical digoxin DI from a Pgp inhibitor occurs at the gut level (the lumen site of human intestine) during digoxin absorption phase?
Thanks for help,
Jack
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The following message was posted to: PharmPK
Jack:
Sorry for the delay. Check out Br J Clin Pharmacol 2003;56:32-38. They gave both oral and IV digoxin with and without clarithromycin.
Carol Collins
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Hi Carol,
Thanks for the information, I appreciate it. The most important piece of data supporting the conclusion of this article (clarithromicin increases oral F of digoxin) seemed to be only moderate change in renal CL was observed with the coadministration. But if one calculates the amount of dig recovered in the urine (0-24 h) it was only ~ 13% of dose. It is apparently not consistent with renal excretion being the main clearance of dig in literature and in this paper (80% of systemic CL). So can we trust the conclusion with the renal data as presented? Your thoughts?
Thanks,
Jack
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