Interaction between digoxin and commonly coadministered drugs in children

Recently, several drugs have been shown to interact with digoxin when coadministered with the cardiac glycoside. Some of these interactions result in toxic accumulation of digoxin. Most of the data available to date derive from adult patients; however, the differences in digoxin pharmacokinetics and pharmacodynamics between children and adults do not permit a direct extrapolation from existing adult data to the pediatric population. In the present communication, current knowledge concerning the interaction of digoxin with six commonly coadministered drugs is reviewed with special focus on our experience with four of these drugs in children. Our observations with indomethacin and amiodarone have recently been published. The data concerning quinidine and aldactone are reported here for the first time.