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JAC Advance Access published online on September 20, 2002
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkf176
© 2002 by The British Society for Antimicrobial Chemotherapy
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© 2002 The British Society for Antimicrobial Chemotherapy

In Brief

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

P. Zapater 1*, S. Reus 2, A. Tello 2, D. Torrús 2, M. Pérez-Mateo 2, J. F. Horga 1

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

* Corresponding author. E-mail: zapaterped{at}gva.es.

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

Abstract

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
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