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Revista de la OFIL
On-line version ISSN 1699-714XPrint version ISSN 1131-9429
Abstract
DE GOROSTIZA FRIAS, C; RAMIREZ CRUZ, S; PENA CABIA, S and GARCIA DIAZ, B. Clinical relevance of the pharmacokinetic interaction between posaconazol and digoxin: a case report. Rev. OFIL·ILAPHAR [online]. 2021, vol.31, n.3, pp.327-329. Epub May 30, 2022. ISSN 1699-714X. https://dx.doi.org/10.4321/s1699-714x20210003000014.
Posaconazole is an inhibitor of glycoprotein P (P-gp), an ATP-dependent transporter with a role in drug absorption, distribution and elimination. Several in vitro studies have shown that digoxin is a substrate of P-gp, so concomitant administration may result in increased intestinal absorption and/or decreased renal clearance, with a consequent risk of digitalic toxicity.
The clinical case of digitalis intoxication as a consequence of the interaction between posaconazole and digoxin in a patient with atrial fibrillation, congestic heart failure and multiple episodes of post-chemotherapy pancytopenia due to acute myeloid leukemia is weighed. The patient had to be hospitalized for bradicardia of 30 l.p.m. Both medicines were immediately suspended and the patient recovered without major issues.
Keywords : P-glycoprotein; drug interactions; digoxin; posaconazole.