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Uwe Peters, MD; Larry C. Falk, MS; Sumner M. Kalman, MD

Arch Intern Med. 1978;138(7):1074-1076.

Abstract
In 100 patients receiving digoxin to control heart disease, metabolic reduction of the lactone ring of digoxin was investigated. An average of 12.4% ±11% (range, 2.2% to 52%) of the lipid-extractable cardenolides in a 24-hour urine sample contained the reduced lactone ring. Fifty-three excreted more than 10% while seven excreted more than 35% of these metabolic products. Reduction was not influenced by age, sex, dose, or blood level of digoxin. One patient who excreted 52% reduced products in the urine had 40% reduced digoxin-metabolites in the blood; the main metabolite was dihydrodigoxin. We found no influence of other drug therapy or concurrent disease on reduction of digoxin in this group.

(Arch Intern Med 138:1074-1076, 1978)

Author Affiliations
From the Department of Pharmacology, Stanford (Calif) University School of Medicine. Dr Peters is a postdoctoral fellow of the Heinrich Hertz Stiftung, Dusseldorf, Germany.

Footnotes
Accepted for publication Aug 3, 1977.

Reprint requests to Department of Pharmacology, Stanford University School of Medicine, Stanford, CA 94305 (Dr Kalman).

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