Drug interactions
Amoxicillin/Clavulanate + Digoxin
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.
Overview
Broad-spectrum antibiotics can increase digoxin exposure in some patients by suppressing intestinal bacteria that inactivate digoxin, potentially leading to elevated levels and toxicity.
Mechanism of action
Reduced intestinal bacterial metabolism of digoxin (eg, Eubacterium species) increases digoxin bioavailability; effect is variable and occurs in a subset of patients.
Clinical management
Monitor for digoxin toxicity and consider checking a serum digoxin concentration within 3–7 days after starting or stopping amoxicillin/clavulanate; adjust digoxin dose if levels rise or symptoms occur. Use closer monitoring in older adults and patients with renal impairment.
Drug reference
References
- Digoxin: Drug Interactions (monograph) – Effects of antibiotics on digoxin concentrations — Lexicomp
- Digoxin: Pharmacology, clinical use, and drug interactions — UpToDate
Frequently asked questions
Can I take Amoxicillin/Clavulanate with Digoxin?
The interaction is rated: Moderate. Broad-spectrum antibiotics can increase digoxin exposure in some patients by suppressing intestinal bacteria that inactivate digoxin, potentially leading to elevated levels and toxicity.
How serious is the interaction between Amoxicillin/Clavulanate and Digoxin?
The interaction is rated: Moderate. Evidence level: Moderate.
How is the interaction between Amoxicillin/Clavulanate and Digoxin managed?
Monitor for digoxin toxicity and consider checking a serum digoxin concentration within 3–7 days after starting or stopping amoxicillin/clavulanate; adjust digoxin dose if levels rise or symptoms occur. Use closer monitoring in older adults and patients with renal impairment.
Why do Amoxicillin/Clavulanate and Digoxin interact?
Reduced intestinal bacterial metabolism of digoxin (eg, Eubacterium species) increases digoxin bioavailability; effect is variable and occurs in a subset of patients.
Full monographs, dosing and an interaction checker in the MediHelp app
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