Tìm theo
Digoxin
Các tên gọi khác (10 ) :
  • 12beta-Hydroxydigitoxin
  • 12β-hydroxydigitoxin
  • 4-[(3S,5R,8R,9S,10S,12R,13S,14S)-3-[(2S,4S,5R,6R)-5-[(2S,4S,5R,6R)-5-[(2S,4S,5R,6R)-4,5-dihydroxy-6-methyl-oxan-2-yl]oxy-4-hydroxy-6-methyl-oxan-2-yl]oxy-4-hydroxy-6-methyl-oxan-2-yl]oxy-12,14-dihydroxy-10,13-dimethyl-1,2,3,4,5,6,7,8,9,11,12,15,16,17-tetradecahydrocyclopenta[a]phenanthren-17-yl]-5H-furan-2-one
  • Digazolan
  • Digossina
  • Digoxin
  • Digoxina
  • Digoxine
  • Digoxinum
  • Lanadicor
Thuốc tim mạch
Thuốc Gốc
Small Molecule
CAS: 20830-75-5
ATC: C01AA02, C01AA05, C01AA08
ĐG : Advanced Pharmaceutical Services Inc.
CTHH: C41H64O14
PTK: 780.9385
A cardiotonic glycoside obtained mainly from Digitalis lanata; it consists of three sugars and the aglycone digoxigenin. Digoxin has positive inotropic and negative chronotropic activity. It is used to control ventricular rate in atrial fibrillation and in the management of congestive heart failure with atrial fibrillation. Its use in congestive heart failure and sinus rhythm is less certain. The margin between toxic and therapeutic doses is small. (From Martindale, The Extra Pharmacopoeia, 30th ed, p666)
Nhận Dạng Quốc Tế & Đặc Tính Hóa Học
Công thức hóa học
C41H64O14
Phân tử khối
780.9385
Monoisotopic mass
780.429606756
InChI
InChI=1S/C41H64O14/c1-19-36(47)28(42)15-34(50-19)54-38-21(3)52-35(17-30(38)44)55-37-20(2)51-33(16-29(37)43)53-24-8-10-39(4)23(13-24)6-7-26-27(39)14-31(45)40(5)25(9-11-41(26,40)48)22-12-32(46)49-18-22/h12,19-21,23-31,33-38,42-45,47-48H,6-11,13-18H2,1-5H3/t19-,20-,21-,23-,24+,25-,26-,27+,28+,29+,30+,31-,33+,34+,35+,36-,37-,38-,39+,40+,41+/m1/s1
InChI Key
InChIKey=LTMHDMANZUZIPE-PUGKRICDSA-N
IUPAC Name
4-[(1S,2S,5S,7R,10R,11S,14R,15S,16R)-5-{[(2R,4S,5S,6R)-5-{[(2S,4S,5S,6R)-5-{[(2S,4S,5S,6R)-4,5-dihydroxy-6-methyloxan-2-yl]oxy}-4-hydroxy-6-methyloxan-2-yl]oxy}-4-hydroxy-6-methyloxan-2-yl]oxy}-11,16-dihydroxy-2,15-dimethyltetracyclo[8.7.0.0^{2,7}.0^{11,15}]heptadecan-14-yl]-2,5-dihydrofuran-2-one
Traditional IUPAC Name
digoxin
SMILES
[H][C@]12CC[C@]3([H])[C@]([H])(C[C@@H](O)[C@]4(C)[C@H](CC[C@]34O)C3=CC(=O)OC3)[C@@]1(C)CC[C@@H](C2)O[C@H]1C[C@H](O)[C@H](O[C@H]2C[C@H](O)[C@H](O[C@H]3C[C@H](O)[C@H](O)[C@@H](C)O3)[C@@H](C)O2)[C@@H](C)O1
Độ tan chảy
217-221
Độ hòa tan
64.8 mg/L (at 25 °C)
logP
1.26
logS
-3.8
pKa (strongest acidic)
7.15
pKa (Strongest Basic)
-3
PSA
203.06 Å2
Refractivity
193.23 m3·mol-1
Polarizability
84.8 Å3
Rotatable Bond Count
7
H Bond Acceptor Count
13
H Bond Donor Count
6
Physiological Charge
0
Number of Rings
8
Bioavailability
0
MDDR-Like Rule
true
Dược Lực Học : 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.
Cơ Chế Tác Dụng : A cardiotonic glycoside obtained mainly from Digitalis lanata; it consists of three sugars and the aglycone digoxigenin. Digoxin has positive inotropic and negative chronotropic activity. It is used to control ventricular rate in atrial fibrillation and in the management of congestive heart failure with atrial fibrillation. Its use in congestive heart failure and sinus rhythm is less certain. The margin between toxic and therapeutic doses is small. (From Martindale, The Extra Pharmacopoeia, 30th ed, p666) Digoxin inhibits the Na-K-ATPase membrane pump, resulting in an increase in intracellular sodium. The sodium calcium exchanger (NCX)in turn tries to extrude the sodium and in so doing, pumps in more calcium. 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.
Dược Động Học :
▧ 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).
▧ Protein binding :
25%
▧ Metabolism :
Hepatic (but not dependent upon the cytochrome P-450 system). The end metabolites, which include 3 b-digoxigenin, 3-keto-digoxigenin, and their glucuronide and sulfate conjugates, are polar in nature and are postulated to be formed via hydrolysis, oxidation, and conjugation.
▧ Route of Elimination :
Following intravenous administration to healthy volunteers, 50% to 70% of a digoxin dose is excreted unchanged in the urine.
▧ Half Life :
3.5 to 5 days
Độc Tính : Toxicity includes ventricular tachycardia or ventricular fibrillation, or progressive bradyarrhythmias, or heart block. LD50 = 7.8 mg/kg (orally in mice).
Chỉ Định : For the treatment and management of congestive cardiac insufficiency, arrhythmias and heart failure.
Tương Tác Thuốc :
  • Acarbose Acarbose may decrease the serum levels of digoin. It is thought that acarbose reduces digoin absorption. Monitor for changes in digoxin serum levels and therapeutic and adverse effects if acarbose is initiated, discontinued or dose changed.
  • Alprazolam The benzodiazepine, alprazolam, may increase the effect of digoxin.
  • Amiodarone Amiodarone may increase the effect of digoxin.
  • Bendroflumethiazide Possible electrolyte variations and arrhythmias
  • Benzthiazide Possible electrolyte variations and arrhythmias
  • Bleomycin The antineoplasic agent decreases the effect of digoxin
  • Bosutinib Bosutinib is a substrate and inhibitor of p-glycoprotein (p-gp) and may increase levels of other p-gp substrates.
  • Bumetanide Possible electrolyte variations and arrhythmias
  • Canagliflozin When coadministered with 300 mg canagliflozin, the AUC and mean peak drug concentration of digoxin increased. Monitor concomitant therapy closely.
  • Carmustine The antineoplasic agent decreases the effect of digoxin
  • Carvedilol Carvedilol may increase the serum levels and effect of digoxin.
  • Chlorothiazide Possible electrolyte variations and arrhythmias
  • Chlorthalidone Possible electrolyte variations and arrhythmias
  • Cholestyramine The resin decreases the effect of digoxin
  • Cinitapride Cinitapride can alter the absorption of digoxin as it simulates gastric emptying.
  • Clarithromycin The macrolide, clarithromycin, may increase the effect of digoxin in 10% of patients.
  • Colestipol The resin decreases the effect of digoxin
  • Cyclophosphamide The antineoplasic agent decreases the effect of digoxin
  • Cyclosporine Cyclosporine may increase the effect of digoxin.
  • Cyclothiazide Possible electrolyte variations and arrhythmias
  • Cytarabine The antineoplasic agent decreases the effect of digoxin
  • Dextrothyroxine The thyroid hormone, dextrothyroxine, decreases the effect of digoxin.
  • Diazepam The benzodiazepine, diazepam, may increase the effect of digoxin.
  • Dihydroquinidine barbiturate Quinine/quinidine increases the effect of digoxin
  • Doxorubicin The antineoplasic agent decreases the effect of digoxin
  • Dronedarone Dronedarone inhibits P-glycoprotein transporter thus increasing serum concentrations of digoxin 2.5-fold.
  • Erythromycin The macrolide, erythromycin, may increase the effect of digoxin in 10% of patients.
  • Ethacrynic acid Possible electrolyte variations and arrhythmias
  • Etravirine Digoxin, when administered concomitantly with etravirine, may experience an increase in serum concentration. It is recommended to monitor serum levels of digoxin and titrate dosage to achieve desired therapeutic range. Pre-emptive dose adjustments are not required.
  • Furosemide Possible electrolyte variations and arrhythmias
  • Gatifloxacin Gatifloxacin increases the effect of digoxin
  • Ginseng Changes in digoxin serum levels
  • Hydrochlorothiazide Possible electrolyte variations and arrhythmias
  • Hydroflumethiazide Possible electrolyte variations and arrhythmias
  • Hydroxychloroquine Hydroxychloroquine increases the effect of digoxin
  • Indapamide Possible electrolyte variations and arrhythmias
  • Itraconazole Itraconazole increases the effect of digoxin
  • Josamycin The macrolide, josamycin, may increase the effect of digoxin in 10% of patients.
  • Levothyroxine The thyroid hormone, levothyroxine, decreases the effect of digoxin.
  • Liothyronine The thyroid hormone, liothyronine, decreases the effect of digoxin.
  • Liotrix The thyroid hormone, liotrix, decreases the effect of digoxin.
  • Liraglutide These agents may have decreased C max and a delayed T max during coadministration.
  • Methimazole The antithyroid agent increases the effect of digoxin
  • Methotrexate The antineoplasic agent decreases the effect of digoxin
  • Methyclothiazide Possible electrolyte variations and arrhythmias
  • Metolazone Possible electrolyte variations and arrhythmias
  • Milnacipran Use of Savella concomitantly with digoxin may be associated with potentiation of adverse hemodynamic effects. Co-administration of Savella and intravenous digoxin should be avoided.
  • Mirabegron Mirabegron increased Cmax and AUC of digoxin. Initiate therapy with digoxin at lowest possible dose. Monitor concomitant therapy closely.
  • Penbutolol Both digitalis glycosides and beta-blockers slow atrioventricular conduction and decrease heart rate. Concomitant use can increase the risk of bradycardia.
  • Penciclovir The multivalent agent decreases the effect of penicillamine
  • Penicillamine Penicillamine decreases the effect of digoxin
  • Polythiazide Possible electrolyte variations and arrhythmias
  • Prazosin Prazosin increases the effect of digoxin
  • Procarbazine The antineoplasic agent decreases the effect of digoxin
  • Propafenone Propafenone increases the effect of digoxin
  • Propylthiouracil The antithyroid agent may increase the effect of digoxin.
  • Quinethazone Possible electrolyte variations and arrhythmias
  • Quinidine Quinine/quinidine increases the effect of digoxin
  • Quinidine barbiturate Quinine/quinidine increases the effect of digoxin
  • Quinine Quinine/quinidine increases the effect of digoxin
  • Rabeprazole Rabeprazole increases the effect of digoxin
  • Ranolazine Ranolazine may increase the serum level of digoxin. Monitor for changes in the serum level and therapeutic and adverse effects of digoxin if ranolazine is initiated, discontinued or dose changed.
  • Ritonavir Ritonavir increases levels/effect of digoxin
  • Spironolactone Increased digoxin levels and decreased effect in presence of spironolactone
  • St. John's Wort St. John's Wort decreases the effect of digoxin
  • Sulfasalazine Sulfasalazine may decrease the effect of digoxin.
  • Telaprevir Telaprevir is a substrate of p-glycoprotein and thus increases the AUC and Cmax of digoxin. This indicates an increased absorption of digoxin. Lowest dose of digoxin should be used first and levels be closely monitored.
  • Telithromycin Telithromycin may increase the plasma concentration of Digoxin. Monitor for changes in Digoxin efficacy/toxicity if Telithromycin is initiated, discontinued or dose changed.
  • Telmisartan Telmisartan may increase plasma Digoxin concentrations. Monitor Digoxin levels and adjust dose as required if Telmisartan is initiated, discontinued or dose changed.
  • Thyroglobulin The thyroid hormone, thyroglobulin, decreases the effect of digoxin.
  • Ticlopidine Ticlopidine may decrease Digoxin levels. Monitor for Digoxin levels with Ticlopidine is initiated, discontinued or dose changed.
  • Tolbutamide Tolbutamide increases the effect of digoxin
  • Tolvaptan Tolvaptan increases serum digoxin concentrations due to competitive inhibition of P-glycoprotein in the liver, intestine, and kidney. P-glycoprotein facilitates digoxin efflux thus inhibition of this protein will increase incidence of adverse effects.
  • Trichlormethiazide Possible electrolyte variations and arrhythmias
  • Trimetrexate The absorption of Digoxin, a cardiac glycoside, may be decreased by antineoplastic agents such as Trimetrexate. Liquid forms of Digoxin do not appear to be significantly affected. Monitor Digoxin tablet efficacy if Trimetrexate therapy is initiated, discontinued or if the dose is altered.
  • Verapamil Verapamil may increase the serum concentration of Digoxin by decreasing its metabolism and clearance. Monitor for changes in the therapeutic/adverse effects of Digoxin if Verpamail is initiated, discontinued or dose changed.
  • Vincristine The antineoplasic agent decreases the effect of digoxin
  • Voriconazole Voriconazole may increase the serum concentration of digoxin. Monitor for increased serum concentrations and toxic effects of digoxin if voriconazole is initiated or dose increased.
Liều Lượng & Cách Dùng : Liquid - Intravenous
Powder, for solution - Intravenous
Solution - Oral
Tablet - Oral
Dữ Kiện Thương Mại
Giá thị trường
Nhà Sản Xuất
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    Sản phẩm biệt dược : Cardioxin
  • Công ty :
    Sản phẩm biệt dược : Cardoxin
  • Công ty : Celon
    Sản phẩm biệt dược : Celoxin
  • Công ty : Opsonin
    Sản phẩm biệt dược : Centoxin
  • Công ty : mibe
    Sản phẩm biệt dược : Digacin
  • Công ty : Mylan
    Sản phẩm biệt dược : Digitek
  • Công ty : Klonal
    Sản phẩm biệt dược : Digocard-G
  • Công ty :
    Sản phẩm biệt dược : DIGOX
  • Công ty : GlaxoSmithKline
    Sản phẩm biệt dược : Digoxina
  • Công ty : Teofarma
    Sản phẩm biệt dược : Eudigox
  • Công ty : Kern
    Sản phẩm biệt dược : Lanacordin
  • Công ty :
    Sản phẩm biệt dược : Lanacrist
  • Công ty : Roche
    Sản phẩm biệt dược : Lanicor
  • Công ty :
    Sản phẩm biệt dược : Lanoxicaps
  • Công ty : GlaxoSmithKline
    Sản phẩm biệt dược : Lanoxin
  • Công ty : GlaxoSmithKline
    Sản phẩm biệt dược : Lenoxin
Đóng gói
Tài Liệu Tham Khảo Thêm
drugbank
http://www.drugbank.ca/drugs/DB00390
KEGG Compound
http://www.genome.jp/dbget-bin/www_bget?cpd:C06956
KEGG Drug
http://www.genome.jp/dbget-bin/www_bget?drug:D00298
BindingDB
http://www.bindingdb.org/bind/chemsearch/marvin/MolStructure.jsp?monomerid=50115625
National Drug Code Directory
http://www.hipaaspace.com/Medical_Billing/Coding/National.Drug.Codes/PDF/62584-989-01
PharmGKB
http://www.pharmgkb.org/drug/PA449319
Wikipedia
http://en.wikipedia.org/wiki/Digoxin
RxList
http://www.rxlist.com/cgi/generic/dig.htm
Drugs.com
http://www.drugs.com/digoxin.html
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