Elkayam U, Parikh K, Torkan B, Weber L, Cohen J L, Rahimtoola S H
Am J Cardiol. 1985 May 1;55(11):1393-5. doi: 10.1016/0002-9149(85)90511-9.
The effect of diltiazem on digoxin serum concentration was evaluated in 9 patients who had been treated chronically for heart disease with digoxin, 0.25 mg/day. The indications for digoxin therapy were arrhythmias in 5 patients and mild heart failure in the other 4. Renal digoxin clearance was also evaluated in 8 of these patients. Serum digoxin concentration was measured at control, 7 +/- 2 days after initiation of 120 mg/day of diltiazem and 11 +/- 5 days after increasing the dose of diltiazem to 240 mg/day. Serum digoxin concentration was 0.9 +/- 0.4 ng/ml at control, 0.8 +/- 0.4 ng/ml with 120 mg/day of diltiazem, and 0.8 +/- 0.3 ng/ml during therapy with 240 mg/day. The differences between these values were not significant. Renal digoxin clearance also did not show a significant change after diltiazem therapy (44 +/- 15 ml/min before diltiazem and 46 +/- 13 ml/min with 240 mg/day of diltiazem). This study shows no effect of diltiazem in doses of 120 to 240 mg/day on serum digoxin concentration or renal digoxin clearance in patients who are treated chronically for heart disease with digoxin. In this dose range, diltiazem has advantages over verapamil, which markedly elevates digoxin levels.
在9例长期接受地高辛（每日0.25毫克）治疗心脏病的患者中，评估了地尔硫䓬对地高辛血清浓度的影响。地高辛治疗的适应症为5例心律失常患者和另外4例轻度心力衰竭患者。其中8例患者还评估了地高辛的肾脏清除率。在基线时、开始每日120毫克地尔硫䓬治疗后7±2天以及地尔硫䓬剂量增加至每日240毫克后11±5天测量血清地高辛浓度。基线时血清地高辛浓度为0.9±0.4纳克/毫升，使用每日120毫克地尔硫䓬时为0.8±0.4纳克/毫升，使用每日240毫克地尔硫䓬治疗期间为0.8±0.3纳克/毫升。这些值之间的差异无统计学意义。地尔硫䓬治疗后肾脏地高辛清除率也未显示出显著变化（地尔硫䓬治疗前为44±15毫升/分钟，使用每日240毫克地尔硫䓬时为46±13毫升/分钟）。本研究表明，每日剂量为120至240毫克的地尔硫䓬对长期接受地高辛治疗心脏病的患者的血清地高辛浓度或肾脏地高辛清除率没有影响。在此剂量范围内，地尔硫䓬比维拉帕米有优势，维拉帕米会显著提高地高辛水平。
