digoxin and Foot-Dermatoses

The case is reported of a 71-year-old woman with clinical signs of digoxin intoxication, presumably developing as a result of the simultaneous use of digoxin for cardiac abnormalities and itraconazole for infection with Candida albicans. Five similar experiences have previously been reported in the literature. Itraconazole may induce a decreased elimination of digoxin, but the mechanism of interaction is still unknown. Comedication and renal function may perhaps contribute to the degree of interaction. When itraconazole is needed in a patient also using digoxin the blood level of the latter drug should be monitored; the daily dose of digoxin may have to be decreased to only one-quarter of the original. Nausea and anorexia may be mistaken for side effects of itraconazole and be overlooked as early signs of digoxin intoxication.

Topics: Aged; Candidiasis, Cutaneous; Digoxin; Drug Synergism; Female; Foot Dermatoses; Humans; Itraconazole