Amiloride: Inhibited digoxin effect and increased digoxin excretion. Monitor child for arrhythmias.
Aminosalicylic acid, antacids containing aluminum or magnesium hydroxide, kaolin-pectin, magne-sium trisilicate, sulfasalazine: Decreased ab-sorption of orally administered digoxin with con-comitant use. Use cautiously if administered to-gether and monitor child for arrhythmias.
Amiodarone, diltiazem, nifedipine, quinidine, ve-rapamil: May cause increased serum digoxin lev-els, predisposing child to toxicity. Watch for car diac effects.
Amphotericin B, carbenicillin, -or-steroids cor ticotropin, edetate disodium, laxatives, sodium polystyrene sulfonate, ticarcillin: Depleted total body potassium, possibly causing digoxin toxic-ity. Monitor potassium levels and cardiac effects. Antibiotics: When used together, certain antibi-otics may interfere with bacterial flora that allow formation of inactive reduction products in GI tract, possibly causing significant increase in digoxin bioavailability and increased serum digox-in levels. Monitor child closely.
Anticholinergics: May increase digoxin absorption of oral digoxin tablets. Monitor child closely. Cardiac drugs affecting AV conduction (such as procainamide, propranolol, verapamil): May cause additive cardiac effects.Monitor child closely.
Cholestyramine, colestipol, metoclopramide: May bind digoxin in GI tract and impair absorption. Monitor child for arrhythmias.
Cytotoxic drugs, radiation therapy: May decrease digoxin absorption if intestinal mucosa is dam-aged. Use digoxin elixir or capsules instead. Mon-itor child closely.
Dextrose-insulin infusions, glucagon, large dex-trose doses: Reduced extracellular potassium, possibly leading to digitalis toxicity. Watch for ar-rhythmias.
Electrolyte-altering drugs such as bumetanide, ethacrynic acid, furosemide, and thiazides:May increase or decrease serum electrolyte lev-els, predisposing child to digoxin toxicity. Mon-itor electrolyte levels; monitor cardiac effects closely.
L V. calcium preparations: May cause synergistic effects that precipitate arrhythmias. Monitor child closely.
Rauwolfia alkaloids, sympathomimetics (such as ephedrine, epinephrine, isoproterenol):May increase risk of arrhythmias. Monitor child closely.
Succinylcholine: May precipitate arrhythmias by potentiating digoxins effects. Monitor child closely. |