1 The Division of Clinical Pharmacology, The Research Institute, The Hospital for Sick Children, Toronto
Quinidine and digoxin had been coadministered in cardiac patients for several decades before their interaction was reported in 1978. During the last few years, monitoring of increased digoxin serum concentration when several drugs are commonly coadministered with digoxin has led to reports of toxic accumulation of the cardiac glycoside. Because digoxin toxicity is frequently associated with severe morbidity and mortality, close monitoring of clinical and laboratory signs are mandatory whenever the cardiac glycoside is coadministered with quinidine, verapamil, amiodarone, nifedipine, and indomethacin.
Because many of the children receiving a combination of digoxin and interacting drugs are outpatients, it is mandatory to take steps to ensure that toxicity will be detected and treated in its early stages.
Submitted on May 7, 1984