Dorian P, Strauss M, Cardella C, David T, East S, Ogilvie R
Department of Medicine, University of Toronto, Canada.
Clin Invest Med. 1988 Apr;11(2):108-12.
Digoxin toxicity developed in two patients awaiting cardiac transplantation upon the initiation of cyclosporine. Toxicity was associated with elevated digoxin concentrations (10.6 and 5.7 nmoles/L), gastrointestinal symptoms, and arrhythmias classic for digoxin toxicity (bidirectional ventricular tachycardia and AV nodal block with accelerated junctional rhythm respectively). A previously unreported drug interaction between cyclosporine and digoxin was suspected and digoxin pharmacokinetics were studied in two additional patients both before and after cyclosporine therapy prior to cardiac transplantation. The study confirmed a significant interaction between cyclosporine and digoxin; the apparent volume of distribution of digoxin decreased by 71% and its plasma clearance decreased by 53%. Until further information regarding the cyclosporine-digoxin interaction is available, this combination should be used with great caution.
两名等待心脏移植的患者在开始使用环孢素后出现了地高辛中毒。中毒与地高辛浓度升高（分别为10.6和5.7纳摩尔/升）、胃肠道症状以及典型的地高辛中毒心律失常（分别为双向室性心动过速和伴有加速交界性心律的房室结阻滞）有关。怀疑环孢素与地高辛之间存在一种此前未报道的药物相互作用，并在另外两名心脏移植前接受环孢素治疗的患者中研究了地高辛的药代动力学，分别在治疗前和治疗后进行。该研究证实了环孢素与地高辛之间存在显著相互作用；地高辛的表观分布容积减少了71%，血浆清除率降低了53%。在获得关于环孢素 - 地高辛相互作用的更多信息之前，应极其谨慎地使用这种联合用药。
