NICHOLAS H.G. HOLFORD, M.SC.
To the editor: The paper by Leahey and colleagues (1) documenting the specificity of the interaction between digoxin and quinidine is a valuable addition to our knowledge of this phenomenon. I believe, however, that their interpretation of the mechanism of the interaction is erroneous. The observations are not in dispute: Quinidine does produce a rapid rise in digoxin concentration that is sustained in both normal volunteers and patients. The studies of Hager and coworkers (2) and Powell and associates (3) clearly show a reduction in the volume of distribution. The sustained elevation of digoxin levels, at steady state, must nevertheless
NICHOLAS H.G. HOLFORD. Quinidine-Digoxin Interaction. Ann Intern Med. 1980;93:638–639. doi: 10.7326/0003-4819-93-4-638
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Published: Ann Intern Med. 1980;93(4):638-639.
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