Drug interactions
digoxin + doxycycline
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
Doxycycline may increase digoxin exposure by suppressing intestinal bacteria that inactivate digoxin, raising risk of toxicity (nausea, vomiting, bradyarrhythmias, visual changes).
Mechanism of action
Suppression of gut flora (e.g., Eubacterium spp.) that convert digoxin to inactive metabolites → increased bioavailability and serum concentrations.
Clinical management
Check a serum digoxin level ~3–5 days after starting and after stopping doxycycline; monitor for toxicity and ECG changes; adjust digoxin dose based on levels, renal function, and clinical status.
Drug reference
References
- Lanoxin (digoxin) Prescribing Information — FDA Label
- Digoxin: Drug information — UpToDate
- Digoxin–Doxycycline drug interaction monograph — Lexicomp
Frequently asked questions
Can I take digoxin with doxycycline?
The interaction is rated: Moderate. Doxycycline may increase digoxin exposure by suppressing intestinal bacteria that inactivate digoxin, raising risk of toxicity (nausea, vomiting, bradyarrhythmias, visual changes).
How serious is the interaction between digoxin and doxycycline?
The interaction is rated: Moderate. Evidence level: Moderate.
How is the interaction between digoxin and doxycycline managed?
Check a serum digoxin level ~3–5 days after starting and after stopping doxycycline; monitor for toxicity and ECG changes; adjust digoxin dose based on levels, renal function, and clinical status.
Why do digoxin and doxycycline interact?
Suppression of gut flora (e.g., Eubacterium spp.) that convert digoxin to inactive metabolites → increased bioavailability and serum concentrations.
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