A new turbidometric digoxin immunoassay on the ADVIA 1650 analyzer is free from interference by spironolactone, potassium canrenoate, and their common metabolite canrenone

Therapeutic Drug Monitoring

Volumn 25, Issue 4, 2003, Pages 478-482

  Datta, Pradip ^a   Dasgupta, Amitava ^b  

^a BAYER CORPORATION   (United States)

^b UNIVERSITY OF TEXAS MEDICAL SCHOOL   (United States)

Author keywords

Fluorescence polarization immunoassay; Interference; Metabolite; Spironolactone; Turbidometric digoxin assay

Indexed keywords

ALDOSTERONE ANTAGONIST; CANRENOATE POTASSIUM; CANRENONE; DIGOXIN; DIURETIC AGENT; DRUG METABOLITE; SPIRONOLACTONE;

ACCURACY; ARTICLE; CONCENTRATION RESPONSE; CONTROLLED STUDY; CROSS REACTION; DEVICE; DRUG BLOOD LEVEL; DRUG DETERMINATION; DRUG MONITORING; FLUORESCENCE POLARIZATION IMMUNOASSAY; HUMAN; MEASUREMENT; PRIORITY JOURNAL; SERUM; TECHNIQUE; TURBIDIMETRY;

CANRENOATE POTASSIUM; CANRENONE; CARDIOTONIC AGENTS; CROSS REACTIONS; DIGOXIN; DRUG INTERACTIONS; FLUORESCENCE POLARIZATION IMMUNOASSAY; HUMANS; SPIRONOLACTONE;

EID: 0041766206     PISSN: 01634356     EISSN: None     Source Type: Journal    
DOI: 10.1097/00007691-200308000-00011     Document Type: Article

References (22)

1. Cook CS, Hauswald CL, Schoenhard GL, et al. Difference in metabolic profile of potassium canrenoate and spironolactone in rat: mutagenic metabolites unique to potassium canrenoate. Arch Toxicol. 1988;61:201-212.
2. Kojima K, Yamamoto K, Fujioka H, et al. Pharmacokinetics of spironolactone and potassium canrenoate in humans. J Pharmacobiodyn. 1985;8:161-166.
3. Vose CW, Boreham DR, Ford GC, et al. Identification of some human urinary metabolites of orally administered potassium canrenoate by stable isotope labeling techniques. Drug Metab Dispos. 1979;7:226-232.
4. Huffman DH. The effects of spironolactone and canrenone in digoxin radioimmunoassay. Res Commun Chem Pathol Pharmacol. 1974;9:787-790.
5. Crothers DC. Interference of spironolactone metabolites in a digoxin radioimmunoassay. Ther Drug Monit. 1989;11:113-114.
6. Lichey J, Schroder R, Rietbrock N. The effect of oral spironolactone and intravenous canrenoate K on the digoxin radioimmunoassay. Int J Clin Pharmacol Biopharm. 1977;15:557-559.
7. Lichey J, Rietrock N, Borner K. The influence of intravenous canrenoate on the determination of digoxin in serum by radio- and enzyme immunoassay. Int J Clin Pharmacol Biopharm. 1979;17:61-63.
8. Silber B, Sheiner LB, Powers JL, et al. Spironolactone-associated digoxin radioimmunoassay interference. Clin Chem. 1979;25:48-50.
9. Morris RG, Frewin DB, Taylor WB, et al. The effect of renal and hepatic impairment and of spironolactone on serum digoxin assay. Eur J Clin Pharmacol. 1988;34:233-239.
10. Pleasants RA, Williams DM, Porter RS, et al. Reassessment of cross-reactivity of spironolactone metabolites with four digoxin assays. Ther Drug Monit. 1989;11:200-204.
11. Foukaridis GN. Influence of spironolactone and its metabolite canrenone on serum digoxin assays. Ther Drug Monit. 1990;12:82-84.
12. Stone JA, Soldin SJ. An update on digoxin. Clin Chem. 1989;35:1326-1331.
13. Okazaki M, Tanigawara Y, Kita T, et al. Cross-reactivity of TDX and OPUS immunoassay system for serum digoxin determination. Ther Drug Monit. 1997;19:657-662.
14. Steimer W, Muller C, Eber B, et al. Intoxication due to negative canrenone interference in digoxin monitoring [letter]. Lancet. 1999;354:1176-1177
15. Steimer W, Muller C, Eber B. Digoxin assays: frequent, substantial, and potentially dangerous interference by spironolactone, canrenone and other steroids. Clin Chem. 2002;48:507-516.
16. Dasgupta A, Saffer H, Wells A. Datta P. Bidirectional (positive/negative) interference of spironolactone, canrenone and potassium canrenoate on serum digoxin measurement: elimination of interference by measuring free digoxin or using a chemiluminescent assay for digoxin. J Clin Lab Anal. 2002;16:172-177.
17. Tal DM. 6,7-Dihydroxy-6,7-dihydrocanrenone isomers: improved synthesis and proton NMR study. Steroids. 1989;54:113-122.
18. Miller JJ, Valdes R. Methods for calculating cross reactivity in immunoassays. J Clin Immunoassay. 1992;15:97-100.
19. Gardiner P, Schrode K, Quinlan D, et al. Spironolactone metabolism: steady state serum levels of the sulfur containing metabolites. J Clin Pharmacol. 1989;29:342-347.
20. Karras K, Seifert W. Pharmacokinetics of canrenone after oral administration of spironolactone and intravenous injection of canrenoate-K in healthy man. Eur J Clin Pharmacol. 1983;25:449-453.
21. Sadee W, Dagcioglu M, Schroder R. Pharmacokinetics of spironolactone, canrenone and canrenoate-K in humans. J Pharmacol Exp Ther. 1973;185:686-695.
22. Ferreri LF, Raisys VA, Opheim KE. Analysis of digoxin concentrations in serum by fluorescence polarization immunoassay: an evaluation. J Anal Toxicol. 1984;8:138-140.