Effect of quinine on digoxin kinetics

Michael Wandell, J. Robert Powell, W. David Hager, Paul E. Fenster, Penelope E. Graves, Kenneth A. Conrad, Steven Goldman

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Six subjects were evaluated for the effect of quinine, the 1‐isomer of quinidine, on digoxin pharmacokinetics. A 1.0‐mg intravenous digoxin dose was given before and during quinine administration, followed by the measurement of digoxin serum and urine concentrations for 96 hr after each dose. Quinine reduced digoxin total body clearance by 26% from 2.98 to 2.22 ml/min/kg (p < 0.03). Digoxin elimination half‐life (t½) was lengthened from 34.2 to 51.8 hr, reflecting a 32% decrease in digoxin elimination rate constant (p < 0.003). Quinine did not reduce digoxin renal clearance or any volumes of distribution. The amount of digoxin excreted into the urine increased from x̄ = 628.29 μg to x̄ = 772.52 μg (p < 0.02). Digoxin nonrenal clearance decreased an average of 55% from 1.2 to 0.55 ml/min/kg (p < 0.05). These results suggest that quinine alters digoxin metabolism or biliary secretion, reducing digoxin total body clearance by a mechanism that is qualitatively similar, but quantitatively different, from quinidine. Clinical Pharmacology and Therapeutics (1980) 28, 425–430; doi:

Original languageEnglish (US)
Pages (from-to)425-430
Number of pages6
JournalClinical Pharmacology & Therapeutics
Issue number4
StatePublished - Oct 1980

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)


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