Ritonavir + Digoxin = Precautionary

Effect on Concentration

Ritonavir
Unknown
Applies within class?
No
Digoxin
Increase
Applies within class?
No

Pharmacologic Effects

Ritonavir
Effect
N/A
Applies within class?
No
Digoxin
Effect
N/A
Applies within class?
No

Interaction History

N/A

Last Updated 22-Nov-2022

Summary

Ritonavir (300 mg po BID) significantly increased digoxin (0.5 mg IV once) AUC0h-infinity by 86% and it's Vd by 77%. Ritonavir decreased nonrenal and renal digoxin clearance by 48% and 35% respectively. Digoxin terminal half-life in plasma increased by 156%. This inhibition of renal digoxin clearance is likely caused by RTV inhibition of P-gp. In addition, these data indicate that RTV promotes digoxin distribution in the body.

Sources

Digoxin vs ritonavir ^

Study Design

Study Results

Study Conclusions

References

Reinhard Ding, Yorki Tayrouz, Klaus-Dieter Riedel, Jrgen Burhenne, Johanna Weiss, Gerd Mikus, Walter E Haefeli. Substantial pharmacokinetic interaction between digoxin and ritonavir in healthy volunteers. Clinical Pharmacology And Therapeutics. 2004; 1: 73-84.