Clarithromycin and Digoxin Toxicity
Authors: Shivang Trivedi
Journal: Annals of Internal Medicine (1998)

Letters1 April 1998Clarithromycin and Digoxin ToxicityShivang Trivedi, MD, Jeffery Hyman, MD, and Edgar Lichstein, MDShivang Trivedi, MDMaimonides Medical Center; Brooklyn, NY 11219Search for more papers by this author, Jeffery Hyman, MDMaimonides Medical Center; Brooklyn, NY 11219Search for more papers by this author, and Edgar Lichstein, MDMaimonides Medical Center; Brooklyn, NY 11219Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-7-199804010-00030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Case reports describing clarithromycin and its probable effect on digoxin metabolism have been sporadically described in the literature [1, 2]. These findings have important implications for patient care because both digoxin and clarithromycin are commonly prescribed medications. We report a case of digoxin toxicity during clarithromycin therapy.A 70-year-old woman had been receiving digoxin, 0.25 mg/d, for the past 4 years for idiopathic cardiomyopathy. Other medications included hydrochlorothiazide, 25 mg/d; isosorbide mononitrate, 30 mg/d; and captopril, 50 mg every 8 hours. The patient began receiving clarithromycin, 500 mg twice daily, for bronchitis. After 4 days of this ...References1. Midoneck SR, Etingin OR. Clarithromycin-related toxic effects of digoxin [Letter]. N Engl J Med. 1995; 333:1505. Google Scholar2. Brown BA, Wallace RJ Jr, Griffith DE, Warden J. Clarithromycin-associated digoxin toxicity in the elderly. Clin Infect Dis. 1997; 24:92-3. Google Scholar3. Lindenbaum J, Rund DG, Butler VP Jr, Tse-Eng D, Saha JR. Inactivation of digoxin by the gut flora: reversal by antibiotic therapy. N Engl J Med. 1981; 305:789-94. Google Scholar Author, Article, and Disclosure InformationAuthors: Shivang Trivedi, MD; Jeffery Hyman, MD; Edgar Lichstein, MDAffiliations: Maimonides Medical Center; Brooklyn, NY 11219 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCardiac glycosidesClarithromycinMacrolide antibioticsDissociative disorder induced by clarithromycin combined with rabeprazole in a patient with gastritisClarithromycin-induced neurotoxicity in adultsANTIBACTERIAL DRUGSANTIDYSRHYTHMIC DRUGSDrug InteractionsPotential Drug–Drug Interactions in the Outpatient SettingMacrolide antibioticsCardiac glycosidesEffect of Clarithromycin on Steady-State Digoxin ConcentrationsPharmacokinetic Aspects of Treating Infections in the Intensive Care UnitHidden dangers of coadministration of antibiotics and digoxin in children: Focus on azithromycinPositive inotropic drugs and drugs used in dysrhythmiasConcomitant Digoxin Toxicity and Warfarin Interaction in a Patient Receiving ClarithromycinDigoxin interaction 1 April 1998Volume 128, Issue 7Page: 604KeywordsBlood urea nitrogenCreatinineElectrocardiographyNauseaPatientsPotassiumThyroid-stimulating hormoneToxicityVisionVomiting ePublished: 15 August 2000 Issue Published: 1 April 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...