Drug interactions
Cholestyramine + Digoxin
Severity: Moderate
Cholestyramine 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
Cholestyramine binds digoxin in the gut and reduces its absorption, and it can also interrupt enterohepatic recirculation. This can lower digoxin concentrations and reduce its therapeutic effect, for example loss of heart rate control.
What this interaction means in plain words
Cholestyramine 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.
Cholestyramine belongs to Cardiovascular; Digoxin belongs to Cardiovascular.
Why it happens
Binding of digoxin in the gastrointestinal tract by the anion-exchange resin, decreasing absorption and enterohepatic recycling.
What to do
Give digoxin at least 2 hours before or 6 hours after cholestyramine, and monitor digoxin levels and heart rate or rhythm.
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 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
Other interactions of Cholestyramine
Frequently asked questions
Can I take Cholestyramine with Digoxin?
MediHelp rates the interaction as moderate. Cholestyramine 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. Cholestyramine binds digoxin in the gut and reduces its absorption, and it can also interrupt enterohepatic recirculation. This can lower digoxin concentrations and reduce its therapeutic effect, for example loss of heart rate control.
How serious is the interaction between Cholestyramine 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: Give digoxin at least 2 hours before or 6 hours after cholestyramine, and monitor digoxin levels and heart rate or rhythm.
What other medicines interact with Digoxin?
MediHelp also lists interactions of Digoxin with, for example, Lily of the valley, Squill, Adagrasib. The full list is on the Digoxin page.
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