medigoxin and Kidney-Diseases

Beta-methyldigoxin (beta-MD) was administered orally (0.2 mg) to 24 patients with various degrees of renal function, to investigate its pharmacokinetic characteristics related to renal function. Serum and urine collected until 120 hours after dosing were assayed for beta-MD and digoxin by high-performance liquid chromatography and fluorescence polarization immunoassay method. The steady-state volume of distribution decreased proportionately as creatinine clearance (CLCR) decreased, although steady-state volume of distribution of hemodialysis patients had large interindividual variability, and their mean value was not different from that of patients with normal renal function. Both renal clearance of beta-MD and digoxin were significantly correlated with CLCR (r = .820, P < .001 and r = .822, P < .01, respectively), and the slope of regression line for beta-MD was only 44% that for digoxin. Significantly reduced urinary excretion of total drug (beta-MD plus digoxin) was shown in patients with CLCR below 50 mL/minute/1.48 m2. This study suggests that the dosage modification is not necessary until CLCR decreases to below 50 mL/minute/1.48 m2, but careful attention should be given in the use of beta-MD in patients with CLCR below this value.

Topics: Adult; Aged; Chromatography, High Pressure Liquid; Digoxin; Female; Hospitals, University; Humans; Kidney; Kidney Diseases; Male; Medigoxin; Middle Aged

Creatinine clearance was evaluated in individuals with varying degrees of renal function following the administration of beta-methyl-digoxin. From the results of the experiment it can be deduced that significantly increased hematic values and renal clearance values definitely lower than normal appear only in patients of a creatinine clearance of less than 50 ml/min. Furthermore, a positive correlation between creatinine clearance values and beta-methyl-digoxin levels was noticed. This correlation was in proportion to the amount of serum albumin. The degree of distribution of free digitalis and digitalis bound to proteins within the vascular system played an important role in the complex kinetics of digoxin. This relationship is suggested as an indirect index of the proportions of free beta-methyl-digoxin and of beta-methyl-digoxin bound to plasma proteins.

Topics: Creatinine; Digoxin; Humans; Kidney; Kidney Diseases; Kidney Function Tests; Medigoxin; Protein Binding; Time Factors