Drug interactions
Canagliflozin-metformin + Digoxin
Severity: Moderate
Canagliflozin-metformin and Digoxin: moderate 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
Canagliflozin can increase digoxin exposure, which may lead to digoxin toxicity such as arrhythmia, nausea or visual disturbance. Metformin and digoxin may also compete for renal cationic secretion, although the clinical impact is less certain.
What this interaction means in plain words
Canagliflozin-metformin and Digoxin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Canagliflozin-metformin belongs to Endocrine; Digoxin belongs to Cardiovascular.
Why it happens
Canagliflozin inhibits P-glycoprotein, reducing digoxin efflux and clearance, and metformin and digoxin may compete for renal tubular secretion.
What to do
Monitor serum digoxin concentrations and ECG after starting canagliflozin-metformin, and reduce the digoxin dose if levels or toxicity signs rise.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Canagliflozin-metformin
Other interactions of Digoxin
- Digoxin + Lily of the valley Contraindicated
- Digoxin + Squill Contraindicated
- Adagrasib + Digoxin Major
- Amiodarone + Digoxin Major
- Amlodipine-hydrochlorothiazide-valsartan + Digoxin Major
- Amphotericin b deoxycholate + Digoxin Major
Frequently asked questions
Can I take Canagliflozin-metformin with Digoxin?
MediHelp rates the interaction as moderate. Canagliflozin-metformin and Digoxin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Canagliflozin can increase digoxin exposure, which may lead to digoxin toxicity such as arrhythmia, nausea or visual disturbance. Metformin and digoxin may also compete for renal cationic secretion, although the clinical impact is less certain.
How serious is the interaction between Canagliflozin-metformin and Digoxin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum digoxin concentrations and ECG after starting canagliflozin-metformin, and reduce the digoxin dose if levels or toxicity signs rise.
What other medicines interact with Canagliflozin-metformin?
MediHelp also lists interactions of Canagliflozin-metformin with, for example, Contrast media, Diatrizoate, Diatrizoate meglumine / diatrizoate. The full list is on the Canagliflozin-metformin page.
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