Evaluating high serum digoxin concentration risk factors interaction between direct oral anticoagulant agents and digoxin

Aim:Digoxin is an anti-arrhythmic drug that also has a positive inotropic property. It is mainly used to control heart rate in nonvalvular atrial fibrillation, and improve ejection fraction in heart failure. In recent years, the frequency of digoxin and a combination of new drug using has been increasing. Therefore, to assess the pharmacokinetic interaction between direct oral anticoagulant agents and cardiovascular drugs is necessary for intoxications. Material and Methods:Patients Serum Digoxin Concentrations levels and digoxin intoxications were evaluated according to risk factors investigated retrospectively Patients Serum Digoxin Concentrations levels <1 ng/ml is accepted as low, 1-2 ng/ml therapeutic range, 2.1-2.4 ng/ml is high and >2.4 ng/ml toxicity. Results:The study consisted of 248 females (60.2%) and 160 males (39.2%). The mean age of the patients was 70.5 years. The average age of patients was 70.5 years. Serum digoxin concentrations of 408 patients; 44.81% were detected in the low therapeutic range, 34.41% in the therapeutic range, 6.23% in the high therapeutic range, 14.55% in the toxic therapeutic range. The mean glomerular filtration rate was 58.45, and the mean Serum Digoxin Concentration was 1.36 ng/ml. The statistically significant relationship between age and Patients Serum Digoxin Concentration was 16.3% (p <0.05). There was a statistically significant relationship between Glomerular Filtration Rate and Serum Digoxin Concentrations; one increased and the other decreased (p <0.05). In patients without atherosclerotic heart disease, Serum Digoxin Concentration was significantly lower than those with atherosclerotic heart disease(p< 0.05). Serum Digoxin Concentrations were significantly higher in patients treated with rivaroxaban, the proportions of which differ significantly from each other at the 0.05 level. Conclusion:Nowadays, the frequency of using digoxin and direct oral anticoagulants together is increasing. The narrow therapeutic level of digoxin necessitates close monitoring due to drug-drug interactions.