A patient who takes digoxin reports taking psyllium (Metamucil) three or four times each month for constipation. The primary care NP should counsel this patient to:
a. decrease fluid intake to avoid cardiac overload.
b. change the laxative to docusate sodium (Colace).
c. take the digoxin 2 hours before taking the psyllium.
d. ask the cardiologist about taking an increased dose of digoxin.
C
Laxatives can affect the absorption of drugs in the intestine by decreasing transit time. Digoxin is a drug that is affected by decreased transit time. Patients should be counseled to take the drugs 2 hours apart.
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