Drug interactions
Ciprofloxacin + 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
Reports of increased digoxin concentrations and toxicity with ciprofloxacin; magnitude is variable.
Mechanism of action
Unknown; proposed mechanisms include inhibition of P-glycoprotein and/or alteration of gut flora that metabolize digoxin.
Clinical management
Monitor for digoxin toxicity and consider checking a digoxin level within several days of starting or stopping ciprofloxacin; adjust digoxin dose if levels rise or toxicity symptoms occur.
Drug reference
References
- Lexicomp Drug Interactions: Digoxin + Ciprofloxacin — Lexicomp
Frequently asked questions
Can I take Ciprofloxacin with Digoxin?
The interaction is rated: Moderate. Reports of increased digoxin concentrations and toxicity with ciprofloxacin; magnitude is variable.
How serious is the interaction between Ciprofloxacin and Digoxin?
The interaction is rated: Moderate. Evidence level: Low.
How is the interaction between Ciprofloxacin and Digoxin managed?
Monitor for digoxin toxicity and consider checking a digoxin level within several days of starting or stopping ciprofloxacin; adjust digoxin dose if levels rise or toxicity symptoms occur.
Why do Ciprofloxacin and Digoxin interact?
Unknown; proposed mechanisms include inhibition of P-glycoprotein and/or alteration of gut flora that metabolize digoxin.
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