atrial fibrillation
2 interactions related to atrial fibrillation
amiodarone + grapefruit
Grapefruit and grapefruit juice inhibit intestinal CYP3A4, the enzyme that metabolizes oral amiodarone. This raises amiodarone blood levels and largely shuts down production of its active metabolite, N-desethylamiodarone. The FDA-approved Pacerone label explicitly states grapefruit juice should not be consumed during oral amiodarone treatment.
alcohol + digoxin
There is no major direct chemical clash between alcohol and digoxin, but alcohol works indirectly to make digoxin less safe. Alcohol can trigger irregular heart rhythms (so-called holiday heart) and, along with diuretics, deplete potassium and magnesium. Because digoxin has a narrow safety margin, those electrolyte shifts make the heart more sensitive to it and raise the risk of digoxin toxicity. Heavy drinking can also worsen the heart failure digoxin is meant to treat.