Monograph

C01AA05 - Digoxin

Not porphyrinogenic

Rationale

Not CYP-metabolised. No data pointing to induction or inhibition of CYPs. Several references state non- porphyrinogenicity. The daily dose is beneath the mg range and hepatocyte exposure beneath the micromolar range.

Therapeutic characteristics

Heart glycoside used in cardiac insufficiency and cardiac arrythmias.

Hepatic exposure

The daily dose is beneath the mg range and hepatocyte exposure beneath the micromolar range.

Metabolism and pharmacokinetics

Although digoxin is reported to be excreted mainly unchanged in the urine there is evidence to suggest that metabolism may sometimes be extensive. Metabolites that have been detected in the urine include digoxigenin, dihydrodigoxigenin, the mono- and bisdigitoxosides of digoxigenin, and dihydrodigoxin. The metabolism of digoxin is not dependent upon the cytochrome P-450 system. Digoxin is not known to induce or inhibit the cytochrome P-450 system.

Personal communication

Andersson, clinical observation (n=1) tolerated.

IPNet drug reports

Uneventful use reported in 3 patients with acute porphyria.

References

#	Citation details	PMID
*	Scientific articles
1.	Moore MR, Hift RJ: Drugs in the acute porphyrias, Cell Mol Biol 43:89, 1997: safe.
2.	Pathologic quiz case: A 35-year-old woman with a history of arrhythmia and liver failure. Archives of Pathology & Laboratory Medicine 2002; 126(6):751-752. Mikolaenko I, Conner MG.

Citation details

PMID

Scientific articles

Moore MR, Hift RJ: Drugs in the acute porphyrias, Cell Mol Biol 43:89, 1997: safe.

Pathologic quiz case: A 35-year-old woman with a history of arrhythmia and liver failure. Archives of Pathology & Laboratory Medicine 2002; 126(6):751-752.

Mikolaenko I, Conner MG.

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Tradenames and packages

From some sources, we get a list of packages (United Kingdom, Ireland, Estonia). Other sources contain more or less "clean" versions of the trade name (Denmark, Finland, Iceland, Lithuania, Norway). What you see here is the raw data we get from each country, so there will appear to be duplicates. The bold names are the searchable terms. The gray names that follow are all mapped to the bolded term.

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Netherlands

Digoxine · Digoxine Eureco-Pharma, oplossing voor injectie 0,5 mg/2 ml · Lanoxin · Lanoxin 125, tabletten 0,125 mg · Lanoxin 250, tabletten 0,25 mg · Lanoxin 250, tabletten 0,250 mg · Lanoxin Injectie, oplossing voor injectie 0,5 mg=2 ml · Lanoxin PG Elixer, drank 0,05 mg/ml · Lanoxin PG, tabletten 0,0625 mg

Belgium

Lanoxin · Lanoxin 0.5 mg/2 ml sol. inj. i.v. flac. · Lanoxin 125 0.125 mg comp. · Lanoxin 250 0.25 mg comp.

United Kingdom

Digamex · Digamex 125microgram tablets · Digamex 250microgram tablets · Digamex 62.5microgram tablets · Digoxin · Digoxin 100micrograms/1ml solution for injection ampoules · Digoxin 125microgram tablets · Digoxin 125micrograms/5ml oral solution · Digoxin 125micrograms/5ml oral suspension · Digoxin 250microgram tablets · Digoxin 250micrograms/5ml oral solution · Digoxin 250micrograms/5ml oral suspension · Digoxin 500micrograms/2ml solution for infusion ampoules · Digoxin 50micrograms/1ml solution for injection ampoules · Digoxin 50micrograms/ml oral solution · Digoxin 62.5microgram tablets · Digoxin 75micrograms/5ml oral solution · Digoxin 75micrograms/5ml oral suspension · Lanoxin · Lanoxin 250microgram tablets · Lanoxin 500micrograms/2ml solution for infusion ampoules · Lanoxin 125 · Lanoxin 125 tablets · Lanoxin Injection Pediatric · Lanoxin Injection Pediatric 100micrograms/1ml solution for injection ampoules · Lanoxin PG · Lanoxin PG 50micrograms/ml elixir · Lanoxin PG 62.5microgram tablets

Denmark