Short CommunicationsThe New Enzyme-Linked Immunosorbent Digoxin Assay on the ADVIA Integrated Modular System® is Virtually Free From Oleander InterferenceDasgupta, Amitava*; Kang, Edward†; Datta, Pradip† Author Information *Department of Pathology and Laboratory Medicine, University of Texas-Houston Medical School, Houston, TX 77030 †Bayer Diagnostics, Tarrytown, New York Reprints: Dr. Amitava Dasgupta, Department of Pathology and Laboratory Medicine, University of Texas-Houston Medical School, 6431 Fannin, MSB 2.292 Houston, Texas (e-mail: [email protected]). Received for publication July 10, 2005; accepted October 24, 2005 Therapeutic Drug Monitoring 28(2):p 282-285, April 2006. | DOI: 10.1097/01.ftd.0000195616.69721.ec Buy Metrics Abstract Despite known toxicity of oleander, this product is used in herbal preparations. Oleander interferes with various digoxin immunoassays. It is possible that a person taking digoxin also may take oleander-containing herbal products, and digoxin immunoassays interfering with oleander cannot be used for therapeutic monitoring of digoxin. Recently, Bayer Diagnostics introduced a new enzyme-linked chemiluminescent immunosorbent digoxin assay for application on the ADVIA IMS® System (ECLIA-digoxin). We studied potential interference of oleander with this new digoxin assay and found that this assay is virtually free from oleander interference. When aliquots of drug-free serum pools were supplemented with ethyl alcohol extract of oleander leaf or pure oleandrin standard, we observed significant apparent digoxin concentration when measured by the fluorescence polarization immunoassay (FPIA) but minimal digoxin-like immunoreactivity using the ECLIA digoxin assay. Because cross-reactivity should be studied in the presence of primary analyte, we prepared 2 serum pools using sera from patients receiving digoxin. Then aliquots of first digoxin pool were supplemented with oleandrin standard and aliquots of second digoxin pool with oleander extract. We observed significant increases in apparent digoxin concentration in the presence of both oleandrin and oleander extract using the FPIA. However, we observed no statistically significant change in digoxin concentration when ECLIA digoxin assay was used, indicating that this assay is virtually free from oleander interference. © 2006 Lippincott Williams & Wilkins, Inc.