Digoxin: profile and news






Simplified treatment regimens show promise in HIV-infected ...  Feb 6, 2006
After switching, all of the children were taking 3TC (lamivudine, Epivir) and abacavir (Ziagen), along with either AZT (zidovudine, Retrovir) or d4T (stavudine ... - Aidsmap,

CROI News Feature: Experts divided over the future of treatment ...  Feb 9, 2006
77% of whom were women) received a HAART regimen comprising two nucleoside reverse transcriptase inhibitors (NRTIs) - AZT (zidovudine, Retrovir) and 3TC ... - Aidsmap,

CROI: Disappointment for glitazones, metformin and testosterone ...  Feb 10, 2006
...are still being investigated, there is increasing agreement that the thymidine analogues, d4T (stavudine, Zerit) and AZT (zidovudine, Retrovir) are major ... - Aidsmap,

CROI: AZT, 3TC and FTC achieve good concentrations in the female ...  Feb 17, 2006
The antiretroviral drugs AZT (zidovudine, Retrovir), 3TC (lamivudine, Epivir) and FTC (emtricitabine, Emtriva) rapidly achieve high concentrations in the ... - Aidsmap,

Multi-component drug delivery system: An emerging trend  Feb 8, 2006
Trizivir), lamivudine/zidovudine (Combivir), stavudine, d4T (Zerit), didanosine, ddI (Videx, Videx EC), zalcitabine, ddC (HIVID), and zidovudine, AZT (Retrovir ... - Express Pharma Pulse,

RFS Pharma Announces 2-Week Data from An NIH-Sponsored Phase 2 ...  Feb 14, 2006
...the K65R mutation show moderate to high cross resistance to the approved drugs, Hivid®, Videx®, Viread® and Epivir® and increased sensitivity to Retrovir ... - PharmaLive.com (press release),

Multi-component drug delivery system: An emerging trend  Feb 8, 2006
Trizivir), lamivudine/zidovudine (Combivir), stavudine, d4T (Zerit), didanosine, ddI (Videx, Videx EC), zalcitabine, ddC (HIVID), and zidovudine, AZT (Retrovir ... - Express Pharma Pulse,

Simplified treatment regimens show promise in HIV-infected ...  Feb 6, 2006
After switching, all of the children were taking 3TC (lamivudine, Epivir) and abacavir (Ziagen), along with either AZT (zidovudine, Retrovir) or d4T (stavudine ... - Aidsmap,

One-pill HIV regimen outperforms gold standard  Jan 19, 2006
...of reducing HIV viral levels and increasing CD4-cell counts after one year of treatment that the gold-standard combination of Sustiva plus Retrovir and Epivir. ... - The Advocate,

ICAAC: Switch from AZT or d4T to tenofovir may improve blood fat ...  Jan 13, 2006
Patients switching from anti-HIV drug regimens containing AZT (zidovudine, Retrovir) or d4T (stavudine, Zerit) may show better improvements in blood fat levels ... - Aidsmap,

Health Beat  Jan 26, 2006
Journal of Medicine on January 19 shows that it is marginally better than another popular and older regimen that combines zidovudine (Retrovir/AZT), lamivudine ... - Bay Area Reporter,

Most people given non-occupational PEP fully adhere to their ...  Jan 19, 2006
In 127 cases, triple antiretroviral therapy consisting of AZT (zidovudine, Retrovir), 3TC (lamivudine, Epivir) and nelfinavir (Viracept) was provided, with the ... - Aidsmap,

John Beale  Jan 19, 2006
The only effective treatment for herpes and shingles, Zovirax, and Retrovir, the first treatment for HIV, both came out of this innovative enterprise. ... - Telegraph.co.uk,

Antiretrovirals To Remain in Short Supply if Steps Not Taken, WHO ...  Nov 14, 2005
GlaxoSmithKline is not increasing production of the antiretroviral Retrovir, also known as zidovudine, despite an increase in demand, according to the AIDS ... - Kaiser network.org,

Worldwide Shortage of Glaxo's AIDS Drug, AZT, Alarms Patients ...  Nov 10, 2005
...information above) to call attention to the worldwide shortage of British drug maker GlaxoSmithKline's (GSK) life-saving AIDS drug, AZT (Retrovir or zidovudine ... - PharmaLive.com (press release),

Psychiatric Manifestations of HIV Infection and AIDS  Dec 5, 2005
The nucleoside reverse transcriptase inhibitor (NRTI) zidovudine (AZT, ZDV, Retrovir) was the earliest antiretroviral drug to be used in the management of HIV. ... - Psychiatric Times,

Gilead's Truvada Better at Suppressing HIV Than GSK's Combivir ...  Nov 21, 2005
...an analysis of data after 24 weeks of the trial, which included 411 HIV-positive patients who switched from Combivir, which combines GSK's Retrovir and Epivir ... - Kaiser network.org,

Number of Pills Affects Adherence to HIV Treatment Regimens  Nov 30, 2005
...to others. COMBIVIR is a combination tablet containing Epivir(R) (lamivudine, 3TC) and Retrovir(R) (zidovudine, AZT). COMBIVIR is ... - PR Newswire (press release),

Number of Pills Affects Adherence to HIV Treatment Regimens  Nov 30, 2005
...to others. Combivir is a combination tablet containing Epivir® (lamivudine, 3TC) and Retrovir® (zidovudine, AZT). Combivir is ... - DG News

Looming AZT Shortage Could Cut Availability of Anti-Aids Drugs  Nov 11, 2005
...commented. The US patent for GSK's AZT drug, Retrovir, expired on 17 September, and its European patent runs out in March 2006. ... - AllAfrica.com,

Pharma RFID Opportunity  Nov 8, 2005
Meanwhile, Pfizer will start tagging its Viagra drug at the end of this year and GlaxoSmithKline intends to tag its Retrovir and Epivir HIV drugs in the next ... - Line 56 News

GlaxoSmithKline's Patent on Retrovir Expires; Generic Versions of ...  Sep 20, 2005
The patent on azidothymidine, or AZT -- the main ingredient in GlaxoSmithKline's antiretroviral drug Retrovir -- expired on Saturday, paving the way for lower ... - Kaiser network.org,

Generic AZT Hits the United States  Oct 10, 2005
19, FDA approved four different generic versions of Retrovir (zidovudine), known as AZT, manufactured by three different companies, for use in the United States ... - PharmExec.com,

FDA clears generic of Glaxo's Retrovir for overseas use  Sep 9, 2005
Hyderabad, India, is the first tentatively approved generic version of Retrovir brand of the zidovudine oral solution (manufactured by GlaxoSmithKline). ... - MarketWatch

Triangle on front lines of evolving war on AIDS  Sep 18, 2005
Some still take Retrovir, the name under which AZT is marketed, as part of a drug cocktail. Many take more powerful drugs containing AZT. ... - News & Observer,

First HIV Drug, Glaxo's AZT, Gets Generic US Rivals (Update1)  Sep 19, 2005
Three drugmakers including Ranbaxy Laboratories Ltd., India's biggest, won the first approvals to sell copies of AZT, also known as Retrovir, in the US, the ... - Bloomberg

10:19 am: Indian company says it has US FDA approval to produce ...  Sep 20, 2005
...said Tuesday that its American subsidiary has received US approval to produce and sell a generic version of the drug Retrovir, used for treating infection by ... - Santa Fe New Mexican,

FDA Approves Four Generic Forms of Zidovudine for US Sales After ...  Sep 21, 2005
...the generic antiretroviral drug zidovudine to be sold in the US, after GlaxoSmithKline's patent on the drug -- sold under the brand name Retrovir -- expired on ... - Kaiser network.org,

FDA OKs generic versions of AIDS drug  Sep 21, 2005
The FDA first approved Retrovir, the brand name for AZT, in 1987. ... The original, sold under the name Retrovir, is manufactured by GlaxoSmithKline. ... - New York Blade,

Aurobindo Receives Tentative FDA Approval To Produce Generic ...  Sep 12, 2005
...based generic drug manufacturer Aurobindo Pharma to produce a generic pediatric version of GlaxoSmithKline's oral antiretroviral drug Retrovir for inclusion in ... - Kaiser network.org,

FDA OKs Generic Versions of AIDS Drug  Sep 20, 2005
The original, sold under the name Retrovir, is manufactured by GlaxoSmithKline. The Food and Drug Administration first approved Retrovir in 1987. ... - Washington Post,

Glaxo’s patent on AZT expires  Sep 20, 2005
GlaxoSmithKline’s patent on Retrovir (AZT), the first approved anti-HIV drug, expired on Saturday, and health experts expect several low-cost generic ... - The Advocate,

FDA Approves Generic Versions of HIV Drug  Sep 21, 2005
21, 2005 -- The FDA has approved the first generic versions of the AIDS drug Retrovir (zidovudine) for sale in the US The approvals include a generic version ... - WebMD

AZT goes generic  Sep 22, 2005
The original, sold under the name Retrovir, is manufactured by GlaxoSmithKline. The FDA first approved Retrovir in 1987. A 300-milligram tablet can cost $7. - TheNewsTribune.com (subscription),

Teva USA Introduces Zidovudine Tablets  Sep 23, 2005
...mg. This product is the same as Retrovir®* Tablets. ... standards.�. * Retrovir® is a registered trademark of Burroughs Wellcome Co. ... - PharmaLive.com (press release),

More National News...  Sep 30, 2005
The original, sold under the name Retrovir, is manufactured by GlaxoSmithKline. The Food & Drug Administration first approved Retrovir in 1987. ... - New York Blade,

Govt Overcomes ARV Shortage  Oct 6, 2005
The company announced that there might be delays in the processing of new orders. The products affected are combivir, retrovir and trizivir. - AllAfrica.com,

AIDS Generic Drugs Approved by FDA for Sale in US  Sep 21, 2005
The drug Retrovir which was approved in 1987, manufactured by GlaxoSmithKline and approved by FDA costs about $7 for one 300 milligram tablet. ... - MedIndia,

Ranbaxy wins USFDA clearance for AIDS drugs  Sep 20, 2005
This is the generic version of the branded Retrovir USP, 300 mg manufactured by GalxoSmithKline and the total annual market sales for Zidovudine 300 mg ... - India Infoline.com,

Ranbaxy Receives Approval to Market Zidovudine Tablets  Sep 20, 2005
...has determined the Ranbaxy formulations to be bioequivalent and have the same therapeutic effect as that of the reference listed drug Retrovir(R) USP, 300 mg ... - PR Newswire (press release),

Aurobindo AIDS drug gets US FDA approval  Sep 12, 2005
...manufactured by Glaxosmithkline. Glaxo sells the drug, that checks the growth of AIDS virus, under the brand Retrovir or atz. Zidovudine is ... - Business Standard,

Ranbaxy gets USFDA approval for Zidovudine  Sep 20, 2005
...has determined the company's formulations to be bio-equivalent and have the same therapeutic effect as that of the reference listed drug Retrovir USP, 300 mg ... - Hindustan Times,

FDA Approves First Pediatric Generic AIDS Drug for US Marketing  Sep 20, 2005
...tablets manufactured by Roxane Laboratories of Columbus, Ohio, USA These are the first generic versions of the already-approved Retrovir brand manufactured by ... - FDA.gov

Ranbaxy gets FDA OK for HIV drug  Sep 20, 2005
Ranbaxy announced Tuesday it had received FDA approval for Zidovudine, a generic equivalent to Retrovir, which is made and marketed by GlaxoSmithKline. ... - Jacksonville Business Journal,

FDA Approves Generic AIDS Drugs For First Time  Sep 20, 2005
AZT was originally manufactured by GlaxoSmithKline and was first approved in 1987 under the name Retrovir. The cost is now approximately $7 per pill. ... - Elites TV,

FDA Approves First Generic AIDS Drugs for Children  Sep 20, 2005
...by children. The original drug, GlaxoSmithKline's Retrovir, was approved in 1987 and keeps the AIDS virus from reproducing. It's ... - HealthCentral.com

Ranbaxy gets US-FDA clearance to market Zidovudine tablets:  Sep 20, 2005
US-FDA, has determined Ranbaxy's formulations to be bioequivalent and having the same therapeutic effect as that of the reference listed drug Retrovir USP, 300 ... - NewKerala.com,

FDA gives tentative approval to Indian AIDS drug  Sep 11, 2005
However, the generic drug will not be available in the United States because of patent protections. Glaxo sells its drug under the name Retrovir, or AZT. ... - Pravda,

First generic versions of AZT approved  Sep 21, 2005
AZT, an antiretroviral drug that is also known as zidovudine or by its brand name Retrovir, helps prevent HIV from reproducing in the body. ... - The Advocate,

Black Health Experts Hail FDA Approval of Generic Drug for HIV ...  Sep 22, 2005
...prepared to go on the market. GlaxoSmithKline created the original AZT treatment, known as Retrovir. A 300-milligram tablet of the ... - Black America Web,

Medical Report  Sep 16, 2005
...the FDA. The drug is sold under the brand Retrovir or ATZ, and it is used with other antiretroviral drugs to treat HIV. BANGALORE ... - Southern Voice,

GLAXO'S PATENT PROTECTION ON FIRST AIDS DRUG, AZT, ENDS; AHF ...  Sep 17, 2005
...free AIDS treatment clinics in the US, Africa, Central America and Asia, today cheered the news that GlaxoSmithKline's (GSK) patent for AZT (Retrovir(R) or ... - ITNews,

Business notebook  Sep 20, 2005
...drug makers and Roxane Laboratories of Columbus, Ohio, won US approval to sell the first generic versions of GlaxoSmithKline's Retrovir pediatric medicine to ... - Boston Globe,

US officials give tentative approval to Indian AIDS drug  Sep 11, 2005
FDA has announced. Glaxo sells the drug, that checks the growth of AIDS virus, under the brand Retrovir or ATZ. Zidovudine is to ... - India Daily,

US clears oral AIDS drug for use overseas  Sep 9, 2005
Glaxo sells its drug under the name Retrovir, or AZT. The nucleoside reverse transcriptase inhibitor helps keep the AIDS virus from multiplying. ... - Reuters South Africa,


Other information


Indication
For the treatment and management of Congestive cardiac insufficiency,arrhythmias and heart failure

Pharmacology
Digoxin, a cardiac glycoside similar to digitoxin, is used to treat congestive heart failure and supraventricular arrhythmias due to reentry mechanisms, and to control ventricular rate in the treatment of chronic atrial fibrillation.

Mechanism Of Action
Digoxin inhibits the Na-K-ATPase membrane pump, resulting in an increase in intracellular sodium and calcium concentrations. Increased intracellular concentrations of calcium may promote activation of contractile proteins (e.g., actin, myosin). Digoxin also acts on the electrical activity of the heart, increasing the slope of phase 4 depolarization, shortening the action potential duration, and decreasing the maximal diastolic potential.

Drug Category
Cardiotonic Agents; Antiarrhythmic Agents; ATC:C01AA02; ATC:C01AA05; ATC:C01AA08

Brand Names/Synonyms
Cardoxin; Cogoxin; Cordioxil; Davoxin; Digacin; Digitalis Glycoside; Digitekt; Digoxin; Digoxin Pediatric; Dilanacin; Dixina; Dokim; Dynamos; Eudigox; Homolle's Digitalin; Lanacordin; Lanacrist; Lanicor; Lanoxicaps; Lanoxin; Lenoxicaps; Lenoxin; Longdigox; Neo-Lanicor; Neodioxanin; Rougoxin; Sk-Digoxin; Stillacor; Vanoxin

Dosage Forms
tablets, capsules, injection

Absorption
Absorption of digoxin from the elixir pediatric formulation has been demonstrated to be 70% to 85% complete (90% to 100% from the capsules, and 60% to 80% for tablets).

Interactions
Interactions for Digoxin:

Potassium-depleting diuretics are a major contributing factor to digitalis toxicity. Calcium, particularly if administered rapidly by the intravenous route, may produce serious arrhythmias in digitalized patients. Quinidine, verapamil, amiodarone, propafenone, indomethacin, itraconazole, alprazolam, and spironolactone raise the serum digoxin concentration due to a reduction in clearance and/or in volume of distribution of the drug, with the implication that digitalis intoxication may result. Erythromycin and clarithromycin (and possibly other macrolide antibiotics) and tetracycline may increase digoxin absorption in patients who inactivate digoxin by bacterial metabolism in the lower intestine, so that digitalis intoxication may result. The risk of this interaction may be reduced if digoxin is given as capsules. Propantheline and diphenoxylate, by decreasing gut motility, may increase digoxin absorption. Antacids, kaolin-pectin, sulfasalazine, neomycin, cholestyramine, certain anticancer drugs, and metoclopramide may interfere with intestinal digoxin absorption, resulting in unexpectedly low serum concentrations. Rifampin may decrease serum digoxin concentration, especially in patients with renal dysfunction, by increasing the non-renal clearance of digoxin. There have been inconsistent reports regarding the effects of other drugs (e.g., quinine, penicillamine) on serum digoxin concentration. Thyroid administration to a digitalized, hypothyroid patient may increase the dose requirement of digoxin. Concomitant use of digoxin and sympathomimetics increases the risk of cardiac arrhythmias. Succinylcholine may cause a sudden extrusion of potassium from muscle cells, and may thereby cause arrhythmias in digitalized patients. Although beta-adrenergic blockers or calcium channel blockers and digoxin may be useful in combination to control atrial fibrillation, their additive effects on AV node conduction can result in advanced or complete heart block.

Due to the considerable variability of these interactions, the dosage of digoxin should be individualized when patients receive these medications concurrently. Furthermore, caution should be exercised when combining digoxin with any drug that may cause a significant deterioration in renal function, since a decline in glomerular filtration or tubular secretion may impair the excretion of digoxin.



Chemical IUPAC Name
4-[3-[5-[5-(4,5-dihydroxy-6-methyl-tetrahydropyran-2-yl)oxy-4-hydroxy-6-methyl-tetrahydropyran-2-yl]oxy-4-hydroxy-6-methyl-tetrahydropyran-2-yl]oxy-12,14-dihydroxy-10,13-dimethyl-2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17-hexadecahydro-1H-cyclopenta[a]phenanthren-17-yl]-5H-furan-2-one

Chemical Formula
C41H64O14

Half Life
3.5 to 5 days

Drug Type
Approved Drug

# Accession No
APRD00098

CAS Registry Number
20830-75-5

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