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Digoxin and warfarin

Konrad H Stopsack, Alexandra J Greenberg, Lorelei A Mucci
PURPOSE: Most prostate cancer patients also have comorbidities that are treated with both prescription and nonprescription medications; furthermore, many use dietary supplements. We assess their association with prognosis after prostate cancer diagnosis, and we discuss methodological challenges and clinical implications. METHODS: We reviewed high-quality observational studies investigating the association of commonly used medications and supplements with prostate cancer-specific mortality...
August 4, 2016: World Journal of Urology
Christian Madelaire, Morten Schou, Karl Emil Nelveg-Kristensen, Michelle Schmiegelow, Christian Torp-Pedersen, Finn Gustafsson, Lars Køber, Gunnar Gislason
BACKGROUND/OBJECTIVES: Digoxin is widely used as symptomatic treatment in heart failure (HF), but the role in contemporary treatment of HF with sinus rhythm (SR) is debatable. We investigated the risk of death and hospital readmission, according to digoxin use, in a nationwide cohort of digoxin-naïve patients with HF and SR. METHODS: From Danish nationwide registries, digoxin-naïve HF patients from 1996 to 2012 were identified. Patients with cardiac dysrhythmias or use of warfarin were excluded...
October 15, 2016: International Journal of Cardiology
Monique Groen-Wijnberg, Jan van Dijk, Walter Krauwinkel, Virginie Kerbusch, John Meijer, Reiner Tretter, Wenhui Zhang, Marcel van Gelderen
BACKGROUND AND OBJECTIVES: Mirabeg ron is a selective β3-adrenoceptor agonist approved for the treatment of overactive bladder (OAB). Four phase 1 studies were conducted in healthy subjects to evaluate the potential for pharmacokinetic interactions between mirabegron and metformin, warfarin, digoxin, or a combination oral contraceptive (COC). METHODS: Thirty-two male subjects received metformin (500 mg twice daily) or mirabegron (160 mg once daily) alone, in combination or with placebo...
June 28, 2016: European Journal of Drug Metabolism and Pharmacokinetics
Kunju M Subair, Prabha Nini Gupta, K Suresh, K R Santhosh, Preetham Kumar Francis, Thomas John, Preeti Sara George
OBJECTIVES: To study the natural history of medically treated patients with endomyocardial fibrosis (EMF) and to see whether the usage of common drugs affected survival. DESIGN: A real-world all-comers analysis with follow-up. SETTING: A teaching hospital. ANALYSIS: Cox proportional hazards multiple regression and Kaplan-Meier curves for survival with both univariate and multivariate analysis. RESULTS: The mean age of this population was 40...
2011: Heart Asia
Hae-Young Lee, Byung-Hee Oh
Fimasartan is the ninth, and most recent, angiotensin II receptor antagonist approved as an antihypertensive agent. Fimasartan, a pyrimidin-4(3H)-one derivative of losartan with the imidazole ring replaced, which enables higher potency and longer duration than losartan. Fecal elimination and biliary excretion are the predominant elimination pathways of fimasartan and the urinary excretion was found to be less than 3 % 24 h after administration. Fimasartan is primarily catabolized by cytochrome P450 isoform 3A and no significant drug interaction was observed when used in combination with hydrochlorothiazide, amlodipine, warfarin, or digoxin...
July 2016: Drugs
S Jill Stocks, Evangelos Kontopantelis, Artur Akbarov, Sarah Rodgers, Anthony J Avery, Darren M Ashcroft
STUDY QUESTION: What is the prevalence of different types of potentially hazardous prescribing in general practice in the United Kingdom, and what is the variation between practices? METHODS: A cross sectional study included all adult patients potentially at risk of a prescribing or monitoring error defined by a combination of diagnoses and prescriptions in 526 general practices contributing to the Clinical Practice Research Datalink (CPRD) up to 1 April 2013. Primary outcomes were the prevalence of potentially hazardous prescriptions of anticoagulants, anti-platelets, NSAIDs, β blockers, glitazones, metformin, digoxin, antipsychotics, combined hormonal contraceptives, and oestrogens and monitoring by blood test less frequently than recommended for patients with repeated prescriptions of angiotensin converting enzyme inhibitors and loop diuretics, amiodarone, methotrexate, lithium, or warfarin...
November 3, 2015: BMJ: British Medical Journal
Prajakta S Badri, Sandeep Dutta, Haoyu Wang, Thomas J Podsadecki, Akshanth R Polepally, Amit Khatri, Jiuhong Zha, Yi-Lin Chiu, Walid M Awni, Rajeev M Menon
The two direct-acting antiviral (2D) regimen of ombitasvir and paritaprevir (administered with low-dose ritonavir) is being developed for treatment of genotype subtype 1b and genotypes 2 and 4 chronic hepatitis C virus (HCV) infection. Drug-drug interactions were evaluated in healthy volunteers to develop dosing recommendations for HCV-infected subjects. Mechanism-based interactions were evaluated for ketoconazole, pravastatin, rosuvastatin, digoxin, warfarin, and omeprazole. Interactions were also evaluated for duloxetine, escitalopram, methadone, and buprenorphine-naloxone...
October 12, 2015: Antimicrobial Agents and Chemotherapy
Sompon Wanwimolruk, Virapong Prachayasittikul
It is well recognized that herbal supplements or herbal medicines are now commonly used. As many patients taking prescription medications are concomitantly using herbal supplements, there is considerable risk for adverse herbal drug interactions. Such interactions can enhance the risk for an individual patient, especially with regard to drugs with a narrow therapeutic index such as warfarin, cyclosporine A and digoxin. Herbal drug interactions can alter pharmacokinetic or/and pharmacodynamic properties of administered drugs...
2014: EXCLI journal
Chia-Lin Chou, Chia-Chen Hsu, Chia-Yu Chou, Tzeng-Ji Chen, Li-Fang Chou, Yueh-Ching Chou
BACKGROUND: Tablet splitting or pill splitting frequently occurs in daily medical practice. For drugs with special pharmacokinetic characters, such as drugs with narrow therapeutic index (NTI), unequal split tablets might lead to erroneous dose titration and it even cause toxicity. OBJECTIVE: The aim of this study was to investigate the frequency of prescribing split NTI drugs at ambulatory setting in Taiwan. SETTING: A population-based retrospective study was conducted using the National Health Insurance Research Database in Taiwan...
December 2015: International Journal of Clinical Pharmacy
Jessie Kang, Bijon Das
Mitral valve prolapse is not commonly on the list of differential diagnosis when a patient presents in the emergency department (ED) in severe distress, presenting with non-specific features such as abdominal pain, tachycardia and dyspnea. A healthy 55-year-old man without significant past medical history arrived in the ED with a unique presentation of a primary mitral valve prolapse with an atrial septal defect uncommon in cardiology literature. Early recognition of mitral valve prolapse in high-risk patients for severe mitral regurgitation or patients with underlying cardiovascular abnormalities such as an atrial septal defect is crucial to prevent morbid outcomes such as sudden cardiac death...
May 2015: Western Journal of Emergency Medicine
Wei-Chun Chen, Wei-Cheng Chen, Chih-Yu Chen, Biing-Ru Wu, Wen-Chien Cheng, Kuo-Hung Lin, Te-Chun Hsia, Wei Chen, Chia-Hung Chen, Chih-Hsin Muo, Wei-Chih Liao, Chia-Hsiang Li
Atrial fibrillation (AF), the most common sustained arrhythmia requiring treatment worldwide, is one of the major causes of ischemic stroke. Although amiodarone is commonly used for rhythm control in AF, its relationship with stroke has rarely been addressed.We evaluated 16,091 patients who were diagnosed with AF (Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] 427.31 and 427.32) between 1998 and 2011; the date of AF diagnosis was set as the index date. Patients with a history of stroke (ICD-9-CM 430-438) who received amiodarone before the index date or during the following 30 days, or who experienced stroke within 30 days of receiving amiodarone were excluded...
May 2015: Medicine (Baltimore)
Jeffrey B Washam, Susanna R Stevens, Yuliya Lokhnygina, Jonathan L Halperin, Günter Breithardt, Daniel E Singer, Kenneth W Mahaffey, Graeme J Hankey, Scott D Berkowitz, Christopher C Nessel, Keith A A Fox, Robert M Califf, Jonathan P Piccini, Manesh R Patel
BACKGROUND: Digoxin is a widely used drug for ventricular rate control in patients with atrial fibrillation (AF), despite a scarcity of randomised trial data. We studied the use and outcomes of digoxin in patients in the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF). METHODS: For this retrospective analysis, we included and classified patients from ROCKET AF on the basis of digoxin use at baseline and during the study...
June 13, 2015: Lancet
Rajeev M Menon, Prajakta S Badri, Tianli Wang, Akshanth R Polepally, Jiuhong Zha, Amit Khatri, Haoyu Wang, Beibei Hu, Eoin P Coakley, Thomas J Podsadecki, Walid M Awni, Sandeep Dutta
BACKGROUND & AIMS: Paritaprevir (administered with ritonavir, PTV/r), ombitasvir (OBV), and dasabuvir (DSV) are direct-acting antiviral agents (DAAs) for the treatment of chronic hepatitis C virus (HCV) infection. Thirteen studies were conducted to characterize drug-drug interactions for the 3D regimen of OBV, PTV/r, and DSV and various medications in healthy volunteers to inform dosing recommendations in HCV-infected patients. METHODS: Mechanism-based drug-drug interactions were evaluated for gemfibrozil, ketoconazole, carbamazepine, warfarin, omeprazole, digoxin, pravastatin, and rosuvastatin...
July 2015: Journal of Hepatology
Ahmed Alansari, Luis Quiel, Noella Boma
A 77-year-old woman presented to the emergency department with a 2-day history of nausea and vomiting. Her medical history included diabetes mellitus, hypertension, atrial fibrillation, dilated cardiomyopathy, and coronary artery disease. Her home medications included aspirin, clopidogrel, warfarin, digoxin, metoprolol, losartan, simvastatin, isosorbide dinitrate, furosemide, and spironolactone. Initial physical examination showed blood pressure of 170/80 mm Hg with a heart rate of 69 beats per minute, otherwise unremarkable...
July 2016: American Journal of Therapeutics
Peter L Thompson, Angus G Thompson, Chris Judkins
About half of all patients who experience an acute coronary syndrome (ACS) in Australia have their conditions managed non-invasively - that is, they do not undergo coronary angiography and revascularisation in hospital. ACS patients whose conditions are managed non-invasively may not receive the same level of evidence-based care as those who receive coronary revascularisation. This article reviews the optimal pharmacological management of ACS managed non-invasively. There is strong evidence to support the prescription of dual antiplatelet therapy (DAPT; aspirin with a P2Y12 inhibitor)...
November 17, 2014: Medical Journal of Australia
Damayanthi Devineni, Prasarn Manitpisitkul, Nicole Vaccaro, Apexa Bernard, Donna Skee, Rao N V S Mamidi, Hong Tian, Sveta Weiner, Hans Stieltjes, Sue Sha, Paul Rothenberg
OBJECTIVE: Drug-drug interactions between canagliflozin, a sodium glucose co-transporter 2 inhibitor approved for the management of type-2 diabetes mellitus, and an oral contraceptive (OC), warfarin, and digoxin were evaluated in three phase 1 studies in healthy participants. METHODS: All studies were open-label; study 1 included a fixed-sequence design, and studies 2 and 3 used a crossover design. Regimens were: study 1: OC (levonorgestrel (150 μg) + ethinyl estradiol (30 μg))/day (day 1), canagliflozin 200 mg/day (days 4 - 8), and canagliflozin with OC (day 9); study 2: canagliflozin 300 mg/day (days 1 - 12) with warfarin 30 mg/day (day 6) in period 1, and only warfarin 30 mg/day (day 1) in period 2, or vice versa; study 3: digoxin alone (0...
January 2015: International Journal of Clinical Pharmacology and Therapeutics
Hege S Blix, Kirsten K Viktil, Tron A Moger, Aasmund Reikvam
UNLABELLED: Drugs with narrow therapeutic index (NTI-drugs) are drugs with small differences between therapeutic and toxic doses. The pattern of drug-related problems (DRPs) associated with these drugs has not been explored. OBJECTIVE: To investigate how, and to what extent drugs, with a narrow therapeutic index (NTI-drugs), as compared with other drugs, relate to different types of drug-related problems (DRPs) in hospitalised patients. METHODS: Patients from internal medicine and rheumatology departments in five Norwegian hospitals were prospectively included in 2002...
January 2010: Pharmacy Practice
E Sánchez Gómez, Y Arco Prados
OBJECTIVE: To identify the pharmacologic interactions of oral anti-cancer drugs provided at an outpatient clinic. MATERIAL AND METHODS: Anti-cancer drugs included in the Phamacotherapeutic Guideline of the Hospital were identified. A literature search was carried out on the pharmacologic interactions in MEDLINE® and EMBASE® (with the filer language English or Spanish, and the descriptors: "name of the anti-cancer drug" AND ("drug interactions" OR "pharmacokinetic")), Up-to-date®, MICROMEDEX® and the drug information sheet for the EMA and the FDA...
July 2014: Farmacia Hospitalaria
Jinxing Chen, Liying Shao, Ling Gong, Fang Luo, Jin'e Wang, Yi Shi, Yu Tan, Qianlong Chen, Yu Zhang, Rutai Hui, Yibo Wang
Inconsistent associations with warfarin dose were observed in genetic variants except VKORC1 haplotype and CYP2C9*3 in Chinese people, and few studies on warfarin dose algorithm was performed in a large Chinese Han population lived in Northern China. Of 787 consenting patients with heart-valve replacements who were receiving long-term warfarin maintenance therapy, 20 related Single nucleotide polymorphisms were genotyped. Only VKORC1 and CYP2C9 SNPs were observed to be significantly associated with warfarin dose...
2014: PloS One
Mintu P Turakhia, Pasquale Santangeli, Wolfgang C Winkelmayer, Xiangyan Xu, Aditya J Ullal, Claire T Than, Susan Schmitt, Tyson H Holmes, Susan M Frayne, Ciaran S Phibbs, Felix Yang, Donald D Hoang, P Michael Ho, Paul A Heidenreich
BACKGROUND: Despite endorsement of digoxin in clinical practice guidelines, there exist limited data on its safety in atrial fibrillation/flutter (AF). OBJECTIVES: The goal of this study was to evaluate the association of digoxin with mortality in AF. METHODS: Using complete data of the TREAT-AF (The Retrospective Evaluation and Assessment of Therapies in AF) study from the U.S. Department of Veterans Affairs (VA) healthcare system, we identified patients with newly diagnosed, nonvalvular AF seen within 90 days in an outpatient setting between VA fiscal years 2004 and 2008...
August 19, 2014: Journal of the American College of Cardiology
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