Long COVID Patterns in the RECOVER-Adult Study
November 21, 2025
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Brand Name :
Acocantherin, Gratibain, Gratus Strophanthin
Synonyms :
G-Strophanthin, ouabaine, oubain
Class :
Cardiotonic
Brand Name :
Acocantherin, Gratibain, Gratus Strophanthin
Synonyms :
G-Strophanthin, ouabaine, oubain
Class :
Cardiotonic
Dosage forms and strengths
atrial fibrillation
In vivo, data suggests the dosage of 0.004 mg/kg intravenously
The suggested starting dose is 24 mg a day orally through a Maintenance dose
In vivo, data suggests the dosage of 0.004 mg/kg intravenously
The suggested starting dose is 24 mg a day orally through a Maintenance dose
Not indicated
Refer adult dosing
serum concentration of cardiac glycosides is increased by amiodarone
side effects of cardiac glycosides are increased by bretylium
thyroid products decrease the concentration of cardiac glycosides in serum
thyroid products decrease the concentration of cardiac glycosides in serum
thyroid products decrease the concentration of cardiac glycosides in serum
thyroid products decrease the concentration of cardiac glycosides in serum
may increase the serum concentration of cardiac glycosides
may increase the serum concentration of cardiac glycosides
may increase the serum concentration of cardiac glycosides
l-methylfolate-pyridoxal 5′-phosphate-methylcobalamine
may increase the arrhythmogenic effect of cardiac glycosides
may increase the arrhythmogenic effect of cardiac glycosides
may increase the arrhythmogenic effect of cardiac glycosides
may increase the arrhythmogenic effect of cardiac glycosides
may increase the arrhythmogenic effect of cardiac glycosides
may increase the arrhythmogenic effect of cardiac glycosides
may increase the arrhythmogenic effect of cardiac glycosides
may have an increased arrhythmogenic effect when combined with cardiac glycosides
may have an increased arrhythmogenic effect when combined with cardiac glycosides
may have an increased arrhythmogenic effect when combined with cardiac glycosides
may have an increased arrhythmogenic effect when combined with cardiac glycosides
may have an increased arrhythmogenic effect when combined with cardiac glycosides
may have an increased arrhythmogenic effect when combined with cardiac glycosides
may decrease the levels of serum concentration of Cardiac Glycosides
may decrease the levels of serum concentration of Cardiac Glycosides
may decrease the levels of serum concentration of Cardiac Glycosides
may decrease the levels of serum concentration of Cardiac Glycosides
calcium salts have the potential to intensify the arrhythmogenic effect of cardiac glycosides
calcium salts have the potential to intensify the arrhythmogenic effect of cardiac glycosides
calcium salts have the potential to intensify the arrhythmogenic effect of cardiac glycosides
calcium salts have the potential to intensify the arrhythmogenic effect of cardiac glycosides
calcium salts have the potential to intensify the arrhythmogenic effect of cardiac glycosides
may diminish the serum concentration of 5-Aminosalicylic Acid Derivatives
may diminish the serum concentration of 5-Aminosalicylic Acid Derivatives
When ouabain is used together with ridaforolimus, this leads to enhanced concentration serum of ouabain
may increase the adverse/toxic effect of cardiac glycosides
may increase the adverse/toxic effect of cardiac glycosides
may increase the adverse/toxic effect of cardiac glycosides
may increase the serum concentration of cardiac glycosides
may increase the serum concentration of cardiac glycosides
may increase the serum concentration of cardiac glycosides
may increase the serum concentration of cardiac glycosides
may increase the serum concentration of cardiac glycosides
may increase the serum concentration of cardiac glycosides
may increase the serum concentration of cardiac glycosides
may increase the serum concentration of cardiac glycosides
may increase the serum concentration of cardiac glycosides
may increase the serum concentration of cardiac glycosides
may decrease the absorption of cardiac glycosides
may enhance the AV-blocking effect of cardiac glycosides
may enhance the AV-blocking effect of cardiac glycosides
may enhance the AV-blocking effect of cardiac glycosides
may enhance the AV-blocking effect of cardiac glycosides
may enhance the AV-blocking effect of cardiac glycosides
may enhance the arrhythmogenic effect of cardiac glycosides
may enhance the arrhythmogenic effect of cardiac glycosides
may enhance the arrhythmogenic effect of cardiac glycosides
may enhance the arrhythmogenic effect of cardiac glycosides
may enhance the arrhythmogenic effect of cardiac glycosides
may enhance the arrhythmogenic effect of cardiac glycosides
may decrease the absorption of cardiac glycosides
may increase the serum concentration of cardiac glycosides
may increase the serum concentration of cardiac glycosides
may enhance the AV-blocking effect of cardiac glycosides
may enhance the AV-blocking effect of cardiac glycosides
may enhance the AV-blocking effect of cardiac glycosides
may enhance the AV-blocking effect of cardiac glycosides
may enhance the AV-blocking effect of cardiac glycosides
may increase the arrhythmogenic effect of cardiac glycosides
may increase the arrhythmogenic effect of cardiac glycosides
may increase the arrhythmogenic effect of cardiac glycosides
may increase the arrhythmogenic effect of cardiac glycosides
may increase the arrhythmogenic effect of cardiac glycosides
may increase the levels of serum concentration of cardiac glycosides
may increase the levels of serum concentration of cardiac glycosides
may increase the levels of serum concentration of cardiac glycosides
may increase the levels of serum concentration of cardiac glycosides
may increase the levels of serum concentration of cardiac glycosides
may increase the arrhythmogenic effect of cardiac glycosides
may increase the arrhythmogenic effect of cardiac glycosides
may increase the arrhythmogenic effect of cardiac glycosides
may increase the arrhythmogenic effect of cardiac glycosides
may increase the arrhythmogenic effect of cardiac glycosides
may enhance the arrhythmogenic effect of cardiac glycosides
may enhance the arrhythmogenic effect of cardiac glycosides
may enhance the arrhythmogenic effect of cardiac glycosides
may enhance the arrhythmogenic effect of cardiac glycosides
may enhance the arrhythmogenic effect of cardiac glycosides
may enhance the arrhythmogenic effect of cardiac glycosides
may enhance the adverse/toxic effect of cardiac glycosides
may enhance the adverse/toxic effect of cardiac glycosides
may enhance the adverse/toxic effect of cardiac glycosides
may enhance the adverse/toxic effect of cardiac glycosides
may increase the risk of adverse effect of cardiac glycosides
may increase the risk of adverse effect of cardiac glycosides
may increase the risk of adverse effect of cardiac glycosides
may enhance the serum concentration of telmisartan
may increase the arrhythmogenic effect of Vitamin D analogs
may increase the toxic effect of thiazide and thiazide like diuretics
lisinopril/hydrochlorothiazideÂ
may increase the toxic effect of thiazide and thiazide like diuretics
may increase the risk of adverse effect of cardiac glycosides
may have an increased adverse effect when combined with cardiac glycosides
may increase the adverse effect of Amphotericin B
may increase the toxic effect when combined
5-Aminosalicylic Acid Derivatives: they may diminish the serum concentration of cardiac glycosides
5-Aminosalicylic Acid Derivatives: they may diminish the serum concentration of cardiac glycosides
may increase the AV-blocking effect when combined
may enhance the serum concentration of each other when combined
may diminish the concentration of serum when combined with cardiac glycosides
neomycin/polymyxin B/bacitracin topical
may diminish the concentration of serum when combined with cardiac glycosides
may diminish the concentration of serum when combined with cardiac glycosides
may diminish the concentration of serum when combined with cardiac glycosides
may diminish the concentration of serum when combined with cardiac glycosides
may have an increased arrhythmogenic effect when combined with cardiac glycosides
may have an increased arrhythmogenic effect when combined with cardiac glycosides
may have an increased arrhythmogenic effect when combined with cardiac glycosides
may have an increased arrhythmogenic effect when combined with cardiac glycosides
may have an increased arrhythmogenic effect when combined with cardiac glycosides
It may enhance the risk of adverse effects when combined with cardiac glycosides
It may enhance the risk of adverse effects when combined with cardiac glycosides
It may enhance the risk of adverse effects when combined with cardiac glycosides
It may enhance the risk of adverse effects when combined with cardiac glycosides
It may enhance the risk of adverse effects when combined with cardiac glycosides
may have an increased arrhythmogenic effect when combined with cardiac glycosides
When acamprosate is used together with ouabain, this leads to reduction in acamprosate excretion
When acyclovir is used together with ouabain, this leads to reduction in acyclovir excretion
When allopurinol is used together with ouabain, this leads to reduction in allopurinol excretion
When ambrisentan is used together with ouabain, this leads to reduction in ambrisentan excretion
When aminohippuric acid is used together with ouabain, this leads to reduction in aminohippuric acid excretion
When asunaprevir is used together with ouabain, this leads to reduction in asunaprevir excretion
When axitinib is used together with ouabain, this leads to reduction in axitinib excretion
When benzylpenicillin is used together with ouabain, this leads to reduction in benzylpenicillin excretion
When bosentan is used together with ouabain, this leads to reduction in bosentan excretion
When captopril is used together with ouabain, this leads to reduction in captopril excretion
When cefaclor is used together with ouabain, this leads to reduction in cefaclor excretion
When cefazolin is used together with ouabain, this leads to reduction in cefazolin excretion
When cefdinir is used together with ouabain, this leads to reduction in cefdinir excretion
When cefotiam is used together with ouabain, this leads to reduction in cefotiam excretion
When ceftibuten is used together with ouabain, this leads to reduction in ceftibuten excretion
When ceftizoxime is used together with ouabain, this leads to reduction in ceftizoxime excretion
When cholecystokinin is used together with ouabain, this leads to reduction in cholecystokinin excretion
When cholic acid is used together with ouabain, this leads to reduction in cholic acid excretion
When cimetidine is used together with ouabain, this leads to reduction in cimetidine excretion
When clofarabine is used together with ouabain, this leads to reduction in clofarabine excretion
When dexamethasone is used together with ouabain, this leads to reduction in dexamethasone excretion
When dinoprostone is used together with ouabain, this leads to reduction in dinoprostone excretion
When doripenem is used together with ouabain, this leads to reduction in doripenem excretion
When elagolix is used together with ouabain, this leads to reduction in elagolix excretion
When enalapril is used together with ouabain, this leads to reduction in enalapril excretion
When estradiol is used together with ouabain, this leads to reduction in estradiol excretion
When ezetimibe is used together with ouabain, this leads to reduction in ezetimibe excretion
When famotidine is used together with ouabain, this leads to reduction in famotidine excretion
When fexofenadine is used together with ouabain, this leads to reduction in fexofenadine excretion
When fluvastatin is used together with ouabain, this leads to reduction in fluvastatin excretion
When glecaprevir is used together with ouabain, this leads to reduction in glecaprevir excretion
When grazoprevir is used together with ouabain, this leads to reduction in grazoprevir excretion
When hydrocortisone is used together with ouabain, this leads to reduction in hydrocortisone excretion
When indomethacin is used together with ouabain, this leads to reduction in indomethacin excretion
When letermovir is used together with ouabain, this leads to reduction in letermovir excretion
When leucovorin is used together with ouabain, this leads to reduction in leucovorin excretion
When levocarnitine is used together with ouabain, this leads to reduction in levocarnitine excretion
When levosalbutamol is used together with ouabain, this leads to reduction in levosalbutamol excretion
When liotrix is used together with ouabain, this leads to reduction in liotrix excretion
When mercaptopurine is used together with ouabain, this leads to reduction in mercaptopurine excretion
When methotrexate is used together with ouabain, this leads to reduction in methotrexate excretion
When mycophenolate mofetil is used together with ouabain, this leads to reduction in mycophenolate mofetil excretion
When paritaprevir is used together with ouabain, this leads to reduction in paritaprevir excretion
When penicillamine is used together with ouabain, this leads to reduction in penicillamine excretion
When piperacillin is used together with ouabain, this leads to reduction in piperacillin excretion
When pitavastatin is used together with ouabain, this leads to reduction in pitavastatin excretion
When pravastatin is used together with ouabain, this leads to reduction in pravastatin excretion
When raloxifene is used together with ouabain, this leads to reduction in raloxifene excretion
When ranitidine is used together with ouabain, this leads to reduction in ranitidine excretion
When relebactam is used together with ouabain, this leads to reduction in relebactam excretion
When repaglinide is used together with ouabain, this leads to reduction in repaglinide excretion
When rosuvastatin is used together with ouabain, this leads to reduction in rosuvastatin excretion
When saxagliptin is used together with ouabain, this leads to reduction in saxagliptin excretion
When simeprevir is used together with ouabain, this leads to reduction in simeprevir excretion
When sitagliptin is used together with ouabain, this leads to reduction in sitagliptin excretion
When sumatriptan is used together with ouabain, this leads to reduction in sumatriptan excretion
When tetracycline is used together with ouabain, this leads to reduction in tetracycline excretion
When tezacaftor is used together with ouabain, this leads to reduction in tezacaftor excretion
When trifluridine is used together with ouabain, this leads to reduction in trifluridine excretion
When valaciclovir is used together with ouabain, this leads to reduction in valaciclovir excretion
When valproic acid is used together with ouabain, this leads to reduction in valproic acid excretion
When voxilaprevir is used together with ouabain, this leads to reduction in voxilaprevir excretion
When zidovudine is used together with ouabain, this leads to reduction in zidovudine excretion
When amiodarone is used together with ouabain, this leads to a rise in the concentration serum of ouabain
When amodiaquine is used together with ouabain, this leads to a rise in the concentration serum of ouabain
When azithromycin is used together with ouabain, this leads to a rise in the concentration serum of ouabain
When chloroquine is used together with ouabain, this leads to a rise in the concentration serum of ouabain
When choline salicylate is used together with ouabain, this leads to a rise in the concentration serum of ouabain
When cinnarizine is used together with ouabain, this leads to a rise in the concentration serum of ouabain
calcium salts enhance the arrhythmogenic effects of cardiac glycosides
calcium salts enhance the arrhythmogenic effects of cardiac glycosides
calcium salts enhance the arrhythmogenic effects of cardiac glycosides
calcium salts enhance the arrhythmogenic effects of cardiac glycosides
macrolide antibiotics increase cardiac glycoside serum concentration
may have an increased adverse effect when combined with cardiac glycosides
may have an increased adverse effect when combined with cardiac glycosides
may have a decrease in excretion when combined with ouabain
synergistic effects may occur
ispaghula husk may lower or decrease the rate of GI absorption of cardiac glycosides
Actions and Spectrum:
Action:
Inhibition of Sodium-Potassium Pump (Na+/K+ Pump): ouabain inhibits the sodium-potassium pump, also known as the Na+/K+ pump, which is an essential protein found in the cell membrane of various cells, including those in the heart. This pump maintains the proper balance of sodium (Na+) and potassium (K+) ions within the cells. ouabain’s inhibition of this pump leads to an increase in the intracellular concentration of sodium, which subsequently affects the movement of other ions.
Spectrum:
Cardiovascular System:
Positive Inotropic Effect: ouabain increases the force of cardiac muscle contractions, making it a positive inotrope. This effect is used in some medical situations to strengthen the heart’s contraction, particularly in cases of congestive heart failure.
Increased Cardiac Output: ouabain can enhance cardiac output by increasing the force of contractions.
headache
Loss of appetite
Heart block
Irregular pulse
Vomiting
Nausea
Black Box Warning:
None
Contraindication/Caution:
Hypersensitivity: Individuals with hypersensitivity or allergic reaction to ouabain or related compounds should avoid its use.
Cardiac Arrhythmias: ouabain can potentially exacerbate or induce cardiac arrhythmias, including ventricular arrhythmias such as ventricular tachycardia or fibrillation. Therefore, it should be avoided in individuals with a history of such arrhythmias.
Heart Disease: Individuals with pre-existing heart conditions should avoid ouabain, as it can increase the heart’s workload and potentially worsen these conditions.
Electrolyte Imbalances: ouabain can affect the balance of essential electrolytes, including potassium and calcium. It should be avoided in individuals with pre-existing electrolyte imbalances.
Renal Impairment: People with kidney problems should exercise caution when considering ouabain use, as it is primarily eliminated through the kidneys and can potentially accumulate in individuals with renal impairment.
Pregnancy and Lactation: The safety of ouabain during pregnancy and lactation has not been well studied, This drug may offer dangers to the developing foetus or nursing infant, thus women who are pregnant or nursing should avoid it.
Pregnancy warnings:Â Â Â
Pregnancy category: N/A
Lactation:Â Excreted into human milk is unknown
Pregnancy Categories:
Category A:Â Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester.
Category B: There were a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.
Category C:Â there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D:Â adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X:Â Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N:Â There is no data available for the drug under this category
Pharmacology: ouabain is a cardiac glycoside.
Pharmacodynamics:
ouabain primarily exerts its pharmacological effects on the heart by inhibiting the sodium-potassium pump (Na+/K+ pump), also known as the sodium-potassium ATPase. This pump maintains the proper balance of sodium and potassium ions within cardiac myocytes (heart muscle cells).
Pharmacokinetics:
Absorption
ouabain is poorly absorbed orally, so it’s typically administered intravenously.
Distribution
It is distributed throughout the body and can accumulate in tissues, particularly the heart and kidneys.
Metabolism
ouabain is metabolized in the liver.
Excretion and Elimination
The kidneys primarily excrete the drug.
Administration:Â
The form and route of administration will depend on the patient’s condition and the healthcare provider’s recommendations.
Patient information leaflet
Generic Name: ouabain
Why do we use ouabain?
ouabain was historically used as a cardiotonic agent to treat heart conditions like congestive heart failure and cardiac arrhythmias. It works by increasing the force of contractions in the heart muscle, which can be helpful in some cardiac conditions.
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