In vitro digitoxin metabolism. Rate-limiting step and alteration following spironolactone pretreatment.

The biotransformation of digitoxin was considered as a linear transformation comprised of dual deoxy sugar cleavages culminating with product conjugation to glucuronic acid. Digitoxin and two metabolites, digitoxigenin bisdigitoxoside and digitoxigenin monodigitoxoside, were each incubated for 1 hr with rat liver slices. Measurements of amounts of various metabolites allowed determination of rate constants, showing the cleavage of the terminal sugar from digitoxigenin bisdigitoxoside to be the rate-limiting step. The inductive action of spironolactone predominately affected the rate-limiting step.