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JAC Advance Access originally published online on September 20, 2002
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Journal of Antimicrobial Chemotherapy (2002) 50, 601-606
© 2002 The British Society for Antimicrobial Chemotherapy

A prospective study of the clarithromycin–digoxin interaction in elderly patients

P. Zapater1,*, S. Reus2, A. Tello2, D. Torrús2, M. Pérez-Mateo2 and J. F. Horga1

1 Department of Clinical Pharmacology, University General Hospital of Alicante, Maestro Alonso 109, 03010 Alicante; 2 Department of Internal Medicine, University General Hospital of Alicante, Alicante, Spain

Received 9 January 2002; returned 14 May 2002; revised 1 July 2002; accepted 15 July 2002

The study was a prospective observational trial carried out to assess the clarithromycin–digoxin interaction in elderly patients chronically taking digoxin. Digoxin concentrations were determined before and after concomitant treatment with clarithromycin. A Bayesian approach was used to calculate digoxin pharmacokinetics. In the seven patients who were studied there was a significant increase in digoxin concentration after 4–7 days of clarithromycin treatment; digoxin clearance and elimination rate constant were 56–60% lower and elimination half-life was 82% longer. The pharmacokinetic clarithromycin–digoxin interaction in the elderly may be much more frequent than has been assumed up to now.

Keywords: clarithromycin, digoxin, pharmacokinetic interaction, Bayesian

* Corresponding author. Tel: +34-965-938-226; Fax: +34-965-938-226; E-mail: zapater_ped{at}gva.es


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