Physical Exercise and Digoxin Binding to Skeletal Muscle: Relation to Exercise Intensity

The effect of a 1 h bicycle exercise test on digoxin concentration in skeletal muscle (thigh) and serum was studied in 10 healthy men, who had ingested digoxin 0.5 mg daily for 2 weeks. During maintenance digoxin treatment each subject performed 2 exercise tests, at 70-90 W and 140-180 W both 24 h after the last dose, at a 2-7 day interval. During exercise at the lower work load the mean skeletal muscle digoxin concentration increased by 9% (n.s.) and the mean serum digoxin concentration decreased by 26% (p less than 0.001). The high work load induced a mean increase in skeletal muscle digoxin of 20% (p less than 0.05) and a mean decrease in serum digoxin of 40% (p less than 0.001). The results indicate that the increased uptake of digoxin into exercised skeletal muscle and the decrease in serum digoxin during exercise is related to the intensity of the exercise.