digoxin and imidafenacin

Plasma digoxin concentrations are increased by the coadministration of anticholinergic drugs, such as propantheline, which decrease gastrointestinal motility. The present study evaluated the effect of imidafenacin, a novel anticholinergic drug, on the pharmacokinetics of digoxin. The effect of imidafenacin on the pharmacokinetics of digoxin was examined in 14 healthy Japanese male subjects in a single-centre, open-label, randomized, two-way crossover study. Subjects received a daily oral dose of digoxin 0.25 mg on days 1 and 2 and digoxin 0.125 mg on days 3 to 8 (period 1). Following a 2-week washout period, digoxin was administered orally for 8 days in a similar manner (period 2). A twice daily dose of imidafenacin 0.1 mg was concomitantly administered with digoxin for 8 days either in period 1 or 2. The geometric mean ratios [GMR] (90% confidence intervals [CIs]) for digoxin C(max) and AUC(0-24) (with/without imidafenacin) at steady state were 0.88 (0.74, 1.04) and 1.00 (0.90, 1.10), respectively. The 90% CIs of GMR for digoxin trough concentration, urinary excretion amount and renal clearance at steady state fell within the range of 0.8 to 1.25. The steady-state pharmacokinetics of digoxin is not affected by concomitant administration of imidafenacin in healthy subjects.

Topics: Adult; Cross-Over Studies; Digoxin; Drug Interactions; Humans; Imidazoles; Male; Muscarinic Antagonists

Topics: Digoxin; Drug Combinations; Drug Interactions; Drug-Related Side Effects and Adverse Reactions; Female; Heart Failure; Humans; Imidazoles; Male; Propantheline

Topics: Biological Availability; Cholinergic Antagonists; Digoxin; Drug Interactions; Humans; Imidazoles; Propantheline; Quinuclidines; Receptors, Muscarinic; Solifenacin Succinate; Tetrahydroisoquinolines

To evaluate the pharmacokinetics of digoxin in humans, a sensitive and specific LC/MS/MS method was developed and validated for the determination of digoxin concentrations in human plasma. The method was shown to be more sensitive, specific, accurate, and reproducible than common techniques such as RIA. For detection, a LC/MS/MS system with electro spray ionization tandem mass spectrometry in the positive ion-multiple reaction-monitoring (MRM) mode was used to monitor precursor to product ions of m/z 798.5-51.5 for digoxin and m/z 782.5-35.5 for the internal standard, digitoxin. The method was validated over a concentration range of 0.02-5 ng/mL and was found to have acceptable accuracy, precision, linearity, and selectivity. The mean extraction recovery from spiked plasma samples was above 80%. Imidafenacin, coadministered in a drug-drug interaction study, had no detectable influence on the determination of digoxin in human plasma. The novel method was applied to a drug-drug interaction study of digoxin and imidafenacin and the characterization of steady-state pharmacokinetics of digoxin in humans after oral administration at a dose of 0.25 mg on days 1 and 2 followed by 0.125 mg daily doses on days 3 through 8.

Topics: Administration, Oral; Anti-Arrhythmia Agents; Cardiotonic Agents; Chromatography, High Pressure Liquid; Digoxin; Humans; Imidazoles; Male; Reproducibility of Results; Solid Phase Extraction; Tandem Mass Spectrometry