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Dronedarone-digoxin interaction in PALLAS: A foxglove connection?

ElMaghawry M, Farouk M - Glob Cardiol Sci Pract (2015)

Bottom Line: In the Permanent Atrial Fibrillation Outcome Study Using Dronedarone on Top of Standard Therapy (PALLAS) study, dronedarone use was associated with an excess risk of stroke, cardiovascular death and hospitalizations.However, an increased level in the serum digoxin level was observed in the dronedarone arm, as it is a potent inhibitor of the P-glycoprotein transport system.The PALLAS subanalysis suggests that digoxin-dronedarone interaction was responsible for the higher arrhythmic death rate observed in the trial.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Aswan Heart Centre, Kasr ElHajjar, Aswan, Egypt.

ABSTRACT
In the Permanent Atrial Fibrillation Outcome Study Using Dronedarone on Top of Standard Therapy (PALLAS) study, dronedarone use was associated with an excess risk of stroke, cardiovascular death and hospitalizations. However, an increased level in the serum digoxin level was observed in the dronedarone arm, as it is a potent inhibitor of the P-glycoprotein transport system. The PALLAS subanalysis suggests that digoxin-dronedarone interaction was responsible for the higher arrhythmic death rate observed in the trial. These data are consistent with several other studies that demonstrate the potential hazard of the use of digoxin in heart failure and/or atrial fibrillation. One must consider other safer alternatives before prescribing digoxin in atrial fibrillation patients.

No MeSH data available.


Related in: MedlinePlus

Digitalis purpura (commonly known as Foxglove).
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4374098&req=5

fig2: Digitalis purpura (commonly known as Foxglove).

Mentions: Digitalis is a genus of about 20 species of herbaceous perennials, shrubs, and biennials that are commonly called foxgloves. The use of digitalis extract containing cardiac glycosides was first described in the English-speaking medical literature by William Withering, in 1785 (Figure 2). Interestingly, Withering (1741–1799) first learned the use of digitalis in treating dropsy, i.e. congestive heart failure, from an old woman who practiced as a folk herbalist in Shropshire.8


Dronedarone-digoxin interaction in PALLAS: A foxglove connection?

ElMaghawry M, Farouk M - Glob Cardiol Sci Pract (2015)

Digitalis purpura (commonly known as Foxglove).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4374098&req=5

fig2: Digitalis purpura (commonly known as Foxglove).
Mentions: Digitalis is a genus of about 20 species of herbaceous perennials, shrubs, and biennials that are commonly called foxgloves. The use of digitalis extract containing cardiac glycosides was first described in the English-speaking medical literature by William Withering, in 1785 (Figure 2). Interestingly, Withering (1741–1799) first learned the use of digitalis in treating dropsy, i.e. congestive heart failure, from an old woman who practiced as a folk herbalist in Shropshire.8

Bottom Line: In the Permanent Atrial Fibrillation Outcome Study Using Dronedarone on Top of Standard Therapy (PALLAS) study, dronedarone use was associated with an excess risk of stroke, cardiovascular death and hospitalizations.However, an increased level in the serum digoxin level was observed in the dronedarone arm, as it is a potent inhibitor of the P-glycoprotein transport system.The PALLAS subanalysis suggests that digoxin-dronedarone interaction was responsible for the higher arrhythmic death rate observed in the trial.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Aswan Heart Centre, Kasr ElHajjar, Aswan, Egypt.

ABSTRACT
In the Permanent Atrial Fibrillation Outcome Study Using Dronedarone on Top of Standard Therapy (PALLAS) study, dronedarone use was associated with an excess risk of stroke, cardiovascular death and hospitalizations. However, an increased level in the serum digoxin level was observed in the dronedarone arm, as it is a potent inhibitor of the P-glycoprotein transport system. The PALLAS subanalysis suggests that digoxin-dronedarone interaction was responsible for the higher arrhythmic death rate observed in the trial. These data are consistent with several other studies that demonstrate the potential hazard of the use of digoxin in heart failure and/or atrial fibrillation. One must consider other safer alternatives before prescribing digoxin in atrial fibrillation patients.

No MeSH data available.


Related in: MedlinePlus