Digoxin pharmacokinetics

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HereWeGo21

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Got a UWorld question that said that Digoxin is excreted primarily unchanged in the urine.

What? Like, what about all the p450 interactions with Digoxin I have heard about throughout my life??

Anyone have any insight into this?
 
Right. I saw this, and so I suspected P-glycoprotein might be involved.

But is this to say that there is NO hepatic p450 interaction with digoxin? Maybe it's the case that the interactions I've learned about for Digoxin, which I thought were p450 interactions, are actually p-gp interactions. It is true, for example, that there's a lot of overlap between the drugs that interact with p-gp and those that interact with p450.

This seems like a drastic turn though and I don't know if I should go into the test with it.
 
Digoxin is associated with bradycardia as well, it's either the drug of choice for bradycardia or causes it, I forgot which one. Can anybody enlighten me with that UWorld question.