血液透析患者においてフェキソフェナジンの服用によりジゴキシンの血清中濃度が低下した症例

概要

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A 60-year-old male was diagnosed with a polycystic kidney disease, and maintenance hemodialysis was initiated on an outpatient basis in February 2002. In February 2004, he was started on 0.125 mg/day of digoxin three times a week after hemodialysis. Later, 60 mg of fexofenadine twice daily was co-administered with the digoxin during 2 periods : August 7 to September 28, 2004 (Period A) and April 13 to December 20, 2005 (Period B). The trough concentration of digoxin tended to be lower in Period A, and the trough concentration of digoxin, which was 1.0 ng/mL just before Period B, decreased gradually to a level less than the limit of detection (0.3 ng/mL) in around 4 months. This decrease was maintained for at least 3 months after discontinuing the administration of fexofenadine. Blood samples were collected before hemodialysis, and the serum concentration of digoxin was measured once a month by enzyme immunoassay. Drugs known to decrease serum digoxin concentrations were not administered during the surveillance period. In conclusion, our findings suggest that the co-administration of fexofenadine with digoxin could decrease the serum concentration of digoxin in patients undergoing hemodialysis.
2008-03-10