Drug interactions
Chlorthalidone + Digoxin
Severity: Major
Chlorthalidone 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
Hypokalemia and hypomagnesemia induced by chlorthalidone sensitize the myocardium to digoxin and increase the risk of digoxin toxicity and arrhythmias. The risk is greater in elderly patients and those with renal impairment.
What this interaction means in plain words
Chlorthalidone 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.
Chlorthalidone belongs to Cardiovascular; Digoxin belongs to Cardiovascular.
Why it happens
Diuretic-induced potassium and magnesium depletion increases digoxin binding to Na+/K+-ATPase and enhances its proarrhythmic effects.
What to do
Monitor serum potassium and magnesium regularly and keep potassium in the normal range. Check digoxin level and ECG if symptoms of toxicity occur.
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?
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Other interactions of Chlorthalidone
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 Chlorthalidone with Digoxin?
MediHelp rates the interaction as major. Chlorthalidone 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. Hypokalemia and hypomagnesemia induced by chlorthalidone sensitize the myocardium to digoxin and increase the risk of digoxin toxicity and arrhythmias. The risk is greater in elderly patients and those with renal impairment.
How serious is the interaction between Chlorthalidone 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 serum potassium and magnesium regularly and keep potassium in the normal range. Check digoxin level and ECG if symptoms of toxicity occur.
What other medicines interact with Chlorthalidone?
MediHelp also lists interactions of Chlorthalidone with, for example, Amifostine, Atenolol-chlorthalidone, Candesartan-hydrochlorothiazide. The full list is on the Chlorthalidone page.
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