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Disposition of Tablet and Capsule Formulations of Digoxin in the Elderly
Author(s) -
Hui James,
Wang YowMing C.,
Chandrasekaran Appavu,
Geraets Douglas R.,
Caldwell James H.,
Robertson Larry W.,
Reuning Richard H.
Publication year - 1994
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1994.tb02858.x
Subject(s) - digoxin , feces , urine , excretion , metabolite , crossover study , medicine , volunteer , pharmacokinetics , capsule , urinary system , drug , pharmacology , gastroenterology , biology , placebo , pathology , heart failure , paleontology , botany , alternative medicine , agronomy
Study Objective . To compare digoxin tablets and liquid‐filled capsules with respect to excretion of the drug and its metabolites in urine and feces at steady state. Design . A randomized, crossover trial, each period lasting 3 weeks, with no washout period. Setting . A university hospital. Patients . Six patients, five of whom were elderly, with histories of gastrointestinal disorders, such as hypochlorhydria, intestinal bacterial overgrowth, and inflammatory bowel disease. Interventions . The patients received digoxin once/day in either tablet or capsule form for 3 weeks, and then were switched to the other formulation. Total urinary and fecal excretion from the last 3 days of each regimen were analyzed for the drug and metabolites. Measurements and Main Results . No statistically significant differences were found between tablets and capsules in recovery of digoxin or its metabolites in urine or feces (p=0.05). One subject had a 4‐fold increase in urinary drug excretion and 50% decrease in fecal excretion after taking the capsules compared with tablets. Intersubject variability in extent and type of metabolite excretion was greater than intrasubject variability. Conclusions . Fecal analyses may be an accurate way to classify patients as formers of digoxin reduction products.