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Drug interactions

Amlodipine-hydrochlorothiazide-valsartan + Digoxin

Severity: Major

Amlodipine-hydrochlorothiazide-valsartan and Digoxin: major interaction.

Last updated

For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.

Summary

Hydrochlorothiazide-induced hypokalemia and hypomagnesemia increase myocardial sensitivity to digoxin and the risk of arrhythmias. Valsartan-related renal changes may also modestly raise digoxin levels.

What this interaction means in plain words

Amlodipine-hydrochlorothiazide-valsartan and Digoxin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Amlodipine-hydrochlorothiazide-valsartan belongs to Cardiovascular; Digoxin belongs to Cardiovascular.

Evidence level: High

Why it happens

Diuretic-induced hypokalemia and hypomagnesemia enhance digoxin toxicity, with possible reduced renal digoxin clearance.

What to do

Monitor potassium, magnesium and renal function regularly and keep potassium in the normal range. Check digoxin levels and watch for toxicity symptoms.

What to ask your pharmacist

  • Does the benefit of taking both outweigh the risk in my case?
  • Do I need any blood test, ECG or other check while on both?
  • What early warning signs should I watch for, and what should I do if they appear?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Amlodipine-hydrochlorothiazide-valsartan with Digoxin?

MediHelp rates the interaction as major. Amlodipine-hydrochlorothiazide-valsartan and Digoxin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Hydrochlorothiazide-induced hypokalemia and hypomagnesemia increase myocardial sensitivity to digoxin and the risk of arrhythmias. Valsartan-related renal changes may also modestly raise digoxin levels.

How serious is the interaction between Amlodipine-hydrochlorothiazide-valsartan and Digoxin?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor potassium, magnesium and renal function regularly and keep potassium in the normal range. Check digoxin levels and watch for toxicity symptoms.

What other medicines interact with Amlodipine-hydrochlorothiazide-valsartan?

MediHelp also lists interactions of Amlodipine-hydrochlorothiazide-valsartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Amlodipine-hydrochlorothiazide-valsartan page.

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