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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Friday, February 10, 2012
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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Friday, February 10, 2012
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Heart Failure |
Carvidilol and Digoxin: Mixing Drugs01/07/2009 |
My father-in-law is 75 years old. He is mildly obese, non-smoker and hypertensive. He had vertigo and he was hospitalised 3 years back. MR Angio revealed: Screening of the brain reveals confluent hyperintense areas involving both cerebellar hemispheres, vermis and right dorso-lateral aspect of medula oblongata. The finding is consistent with infarctions. Impression: MR Angiography reveals Complete block of right posterior inferior cerebral artery; Atheroclerotic changes involving opecular and insular branches of middle cerebral arteries on either side. 2D Echo LV dysfunction (cyst + Dyst). More than mild MR Severe IVS and LV-RWMA at rest NO IV clots. He is taking Clopigrel 75: Aspirin 75 Cardivilol 6.250 twice; Ramipril 10; Losartan 25 mg; HCTZ 12.5; Simvastatin 10; Aminodorone 100; Monp sorbitrate 20; Minpipress XL 2.5. A few days back he had LVF and was hospitalized. Lanoxin and Torasemide 10 mg were added over the above mentioned drugs. Now he is fine. The cardiologist increased carvrdivilol 6.25 to 12.5 twice but omitted digoxin. Is concommittant use of carvidlol and digoxin contraindicated ?
Carvedilol (Coreg) is used to treat high blood pressure, congestive heart failure, and other cardiac problems. It works by slowing the heart beat. Digoxin (Lanoxin/Digitek) is used to treat congestive heart failure and irregular heart beat. It works by increasing the strength of the heart beat and by making it more regular.The combination of carvedilol and digoxin taken together may result in an interaction that causes the level of digoxin to be higher in the blood than it should be. If digoxin levels rise too much, the patient may have unwanted side effects. Signs that levels of digoxin in the blood are too high may be heart palpitations, weakness, tiredness, vision changes (blurry vision, yellow-green tint to objects), nausea, vomiting, dizziness, headache, confusion, and agitation. It is important to report any side effects to your doctor as soon as they occur. Digoxin levels may be measured by means of a blood test. Patients may need to get blood drawn by the doctor on a regular basis to keep track of levels of digoxin, and to make sure they are not too high or low.
Another potential effect of the combination of carvedilol and digoxin is the possibility for creating an irregular heart beat. This may be caused when the heart beat becomes too slow. This may be a problem for some patients, especially those that already have cardiac problems. The use of both carvedilol and digoxin together is not completely contraindicated, but careful monitoring is required when a patient is on both of these drugs.
It is important to discuss the aspects of a patient's treatment with all doctors involved with that patient's care. Ensure that all people involved with the care of a patient are informed, and up to date, on current medication therapy by maintaining good communication with all care givers and doctors.
Submitted by Casey McCann, PharmD Candidate, University of Cincinnati
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Jan Scaglione, BS MT, PharmD ,DABAT Assistant Professor of Pharmacy Practice Drug and Poison Information Center Cincinnati Children’s Hospital Medical Center University of Cincinnati |
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