Question about ranolazine and digoxin

[mik30102]

Hello I was just wondering why a pharmcodynamic interaction does not come up between these drugs. My way of thinking is that ranolazine stops calcium overload in angina patients by inhibiting late sodium current, increasing the activity of the Na/Ca exchanger to get more calcium out of the cell cutting down on calcium overload. Digoxin will have opposite effects inhibiting the Na/K atpase, leading to more sodium in the cell which will decrease the activity of the Na/Ca exchanger, leading to more calcium in the cell (which is why it has iontrophic effects). Aren't these mechanisms at odds with each other, and shouldn't there be a interaction due to this?

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[mik30102]

No one? Dont be shy

 

[knight on horse]

Inotropic not "iontrophic" (ionotropic). Strength of heartbeat

While these effects as you describe them are ion mediated, inotrope is a separate word.

A proper addressing of the fundamental question will wait till some daytime when I am better slept