Digoxin toxicity precipitated by clarithromycin use: case presentation and concise review of the literature

Can J Cardiol. 2011 Nov-Dec;27(6):870.e15-6. doi: 10.1016/j.cjca.2011.06.006. Epub 2011 Sep 9.

Abstract

We present a case of digoxin toxicity in the context of dehydration, renal dysfunction and concomitant use of the macrolide antibiotic, clarithromycin, which is known to inhibit P-glycoprotein-mediated efflux mechanisms of digoxin. A focused review of the literature is presented. Health care providers need to be vigilant of this mechanism of drug-drug interaction, which is also relevant to other commonly used cardiovascular drugs.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Anti-Arrhythmia Agents / adverse effects*
  • Anti-Arrhythmia Agents / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Clarithromycin / therapeutic use*
  • Digoxin / adverse effects*
  • Digoxin / therapeutic use
  • Drug Interactions
  • Follow-Up Studies
  • Heart Failure / complications
  • Heart Failure / drug therapy*
  • Humans
  • Kidney Diseases / chemically induced*
  • Kidney Diseases / diagnosis
  • Male
  • Pneumonia / complications
  • Pneumonia / drug therapy*

Substances

  • Anti-Arrhythmia Agents
  • Anti-Bacterial Agents
  • Digoxin
  • Clarithromycin