Drug interactions
Charcoal + Digoxin
Severity: Moderate
Charcoal 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
Activated charcoal adsorbs oral digoxin and interrupts its enterohepatic recirculation, lowering serum levels. This is helpful in digoxin toxicity but can reduce efficacy if given at therapeutic doses.
What this interaction means in plain words
Charcoal 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.
Charcoal belongs to Gastrointestinal Tract; Digoxin belongs to Cardiovascular.
Why it happens
Charcoal binds digoxin in the gut, decreasing absorption and enterohepatic recycling.
What to do
Avoid charcoal in routine therapy or separate it from digoxin by several hours. In digoxin poisoning, charcoal is appropriate along with digoxin-specific antibody fragments and monitoring of levels and potassium.
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 Charcoal
- Charcoal + Citalopram Moderate
- Charcoal + Leflunomide Moderate
- Charcoal + Methotrexate Moderate
- Charcoal + Theophylline Moderate
- Charcoal + Tiratricol Moderate
- Acarbose + Charcoal Minor
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 Charcoal with Digoxin?
MediHelp rates the interaction as moderate. Charcoal 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. Activated charcoal adsorbs oral digoxin and interrupts its enterohepatic recirculation, lowering serum levels. This is helpful in digoxin toxicity but can reduce efficacy if given at therapeutic doses.
How serious is the interaction between Charcoal 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: Avoid charcoal in routine therapy or separate it from digoxin by several hours. In digoxin poisoning, charcoal is appropriate along with digoxin-specific antibody fragments and monitoring of levels and potassium.
What other medicines interact with Charcoal?
MediHelp also lists interactions of Charcoal with, for example, Citalopram, Leflunomide, Methotrexate. The full list is on the Charcoal page.
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