How much time should elapse between the administration of Cedilan (digoxin) and calcium supplements?

In clinical practice, the administration of digoxin and calcium-containing agents requires careful consideration of the time interval to avoid potential drug interactions.

Digoxin is primarily used in the treatment of heart failure, where it slows heart rate and enhances myocardial contraction. However, one must be cautious of adverse effects such as nausea, vomiting, and diarrhea, and concomitant use with calcium preparations should be avoided to prevent serious side effects such as digitalis toxicity. This is because digoxin, as an Na-K-ATPase inhibitor, has a synergistic effect with calcium. When used together, calcium preparations may enhance the cardiac effects of digoxin, thereby increasing the risk of cardiac toxicity, such as arrhythmias.

It is recommended to avoid or use calcium-containing agents cautiously during digoxin therapy. If concomitant administration is necessary, it should be done under the guidance of a physician. Generally, a minimum interval of two hours between digoxin and calcium administration is advised, along with close monitoring of the patient's electrocardiogram (ECG) and serum electrolyte levels, particularly potassium and calcium concentrations. Furthermore, digoxin is contraindicated in patients with myocarditis or hypokalemia, and these patients should avoid using this medication.