相互作用
Digoxin + Furosemide
重症度: 重大
Digoxin and Furosemide: major interaction.
最終更新日 出典: US FDA label
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概要
Furosemide can cause hypokalemia and hypomagnesemia, which markedly increase myocardial sensitivity to digoxin and the risk of arrhythmias even at normal serum digoxin concentrations. Volume depletion and reduced renal function from diuresis may also reduce digoxin clearance. The combination is very common in heart failure, so electrolyte monitoring is essential.
この相互作用をわかりやすく説明すると
Digoxin and Furosemide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Digoxin belongs to Cardiovascular; Furosemide belongs to Cardiovascular.
なぜ起こるのか
Pharmacodynamic: loop diuretic-induced potassium and magnesium depletion potentiates digoxin's effects on cardiac automaticity and conduction. Pharmacokinetic: volume depletion or acute kidney injury can reduce renal digoxin clearance.
対処法
Check potassium, magnesium and creatinine at baseline, after starting or changing the furosemide dose, and periodically thereafter. Correct deficits, using potassium supplements, a potassium-sparing diuretic, an ACE inhibitor or an MRA where appropriate.
薬剤師に尋ねること
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
Pro+会員向け
ページ全体を見る
アカウントを作成してPro+トライアルを始めると、DigoxinとFurosemideの臨床対応の詳細なアドバイス、追加の注記、エビデンスの詳細、処方全体を対象とした相互作用チェッカーを利用できます。
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
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参考文献
Digoxinのその他の相互作用
Furosemideのその他の相互作用
よくある質問
Can I take Digoxin with Furosemide?
MediHelp rates the interaction as major. Digoxin and Furosemide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Furosemide can cause hypokalemia and hypomagnesemia, which markedly increase myocardial sensitivity to digoxin and the risk of arrhythmias even at normal serum digoxin concentrations. Volume depletion and reduced renal function from diuresis may also reduce digoxin clearance. The combination is very common in heart failure, so electrolyte monitoring is essential.
How serious is the interaction between Digoxin and Furosemide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check potassium, magnesium and creatinine at baseline, after starting or changing the furosemide dose, and periodically thereafter. Correct deficits, using potassium supplements, a potassium-sparing diuretic, an ACE inhibitor or an MRA where appropriate.
What other medicines interact with Digoxin?
MediHelp also lists interactions of Digoxin with, for example, Lily of the valley, Squill, Adagrasib. The full list is on the Digoxin page.
完全なモノグラフ、用量、相互作用チェッカーはMediHelpアプリで
MediHelpアプリで、完全なリファレンスを開き、複数薬剤の相互作用をチェックし、用量ツールを利用できます。
