[Digitalis intoxication secondary to treatment with clarithromycin]. / Original Breve Intoxicación digitálica secundaria al tratamiento con claritromicina.

OBJECTIVE: The goal of this study was to investigate the percentage of patients concurrently receiving digoxin and clarithromycin who exhibited serum digoxin concentrations above the therapeutic range because of a likely interaction between both drugs, and whether digitalis intoxication ensued. METHOD: A descriptive, retrospective study carried out from January 2002 to December 2003 in all inpatients concurrently receiving digoxin and clarithromycin whose serum digoxin concentrations were monitored by the Pharmacy Department s Pharmacokinetics Section. RESULTS: Twenty-six patients having received digoxin and clarithromycin concurrently during their hospital stay were included in the study. Of these, 12 patients (46.2%) had serum digoxin concentrations above the therapeutic range: 7 received digoxin in doses unsuited for their age and/or renal function, and 2 fell short of the mean period of time considered adequate for an interaction to occur. Therefore, only 3 patients had serum digoxin concentrations above the therapeutic range, probably because of an interaction with clarithromycin, and all three had digitalis intoxication symptoms. CONCLUSIONS: According to the results of our study, 11.5% of patients concurrently receiving digoxin and clarithromycin had serum digoxin concentrations above the therapeutic range because of a likely interaction between these two drugs, with digitalis intoxication ensuing. Thus, we deem it necessary to monitor serum digoxin concentrations in patients receiving clarithtomycin.

Intoxicación digitálica secundaria al tratamiento con claritromicina / Digitalis intoxication secondary to treatment with clarithromycin

Objetivo: El objetivo del estudio es conocer el porcentaje de pacientes en tratamiento simultáneo con digoxina y claritromicina que presentaron concentraciones séricas de digoxina superiores al rango terapéutico debido a una probable interacción entre ambos fármacos y como consecuencia si existió intoxicación digitálica. Método: Estudio descriptivo y retrospectivo realizado entre enero de 2002 y diciembre de 2003 de todos aquellos pacientes que durante su ingreso hospitalario fueron tratados simultáneamente con digoxina y claritromicina y cuyas concentraciones séricas de digoxina fueron monitorizadas por la sección de farmacocinética del servicio de farmacia. Resultados: Se incluyeron en el estudio 26 pacientes que habían recibido con comitantemente digoxina y claritromicina durante su estancia en el hospital. De ellos, 12 pacientes (46,2%) tuvieron concentraciones séricas de digoxina superiores al rango terapéutico: 7 tenían una dosis de digoxina no adecuada para su edad y/o función renal y 2 no superaban el tiempo medio considerado suficiente para que tuviera lugar la interacción. Por lo tanto, sólo 3 pacientes tuvieron concentraciones séricas de digoxina superiores al rango terapéutico debido probablemente a la interacción con claritromicina y los tres presentaron síntomas de intoxicación digitálica. Conclusiones: Según los resultados de nuestro estudio un 11,5% de los pacientes en tratamiento simultáneo con digoxina y claritromicina presentaron concentraciones séricas de digoxina superiores al rango terapéutico, debido a una probable interacción entre ambos fármacos, y como consecuencia tuvo lugar la intoxicación digitálica. Por ello consideramos necesaria la monitorización de las concentraciones séricas de digoxina en pacientes tratados con claritromicina

Objective: The goal of this study was to investigate the percentage of patients concurrently receiving digoxin and clarithromycin who exhibited serum digoxin concentrations above the therapeutic range because of a likely interaction between both drugs, and whether digitalis intoxication ensued. Method: A descriptive, retrospective study carried out from January 2002 to December 2003 in all inpatients concurrently receiving digoxin and clarithromycin whose serum digoxin concentrations were monitored by the Pharmacy Department’s Pharmacokinetics Section. Results: Twenty-six patients having received digoxin and clarithromycin concurrently during their hospital stay were included in the study. Of these, 12 patients (46.2%) had serum digoxin concentrations above the therapeutic range: 7 received digoxin indoses unsuited for their age and/or renal function, and 2 fell short of the mean period of time considered adequate for an interaction to occur. Therefore, only 3 patients had serum digoxin concentrations above the therapeutic range, probably because of an interaction with clarithromycin, and all three had digitalis intoxication symptoms. Conclusions: According to the results of our study, 11.5% of patients concurrently receiving digoxin and clarithromycin had serum digoxin concentrations above the therapeutic range because of a likely interaction between these two drugs, with digitalis intoxication ensuing. Thus, we deem it necessary to monitor serum digoxin concentrations in patients receiving clarithromycin