Drug interactions
Digoxin + Elvitegravir / cobicistat / emtricitabine / tenofovir df
Severity: Major
Digoxin and Elvitegravir / cobicistat / emtricitabine / tenofovir df: 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
The cobicistat component inhibits P-glycoprotein, which can raise digoxin concentrations. This may cause digoxin toxicity given its narrow therapeutic index.
What this interaction means in plain words
Digoxin and Elvitegravir / cobicistat / emtricitabine / tenofovir df 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.
Why it happens
Cobicistat inhibits P-glycoprotein, increasing digoxin absorption and reducing its elimination.
What to do
Check a baseline digoxin level and begin with a lower digoxin dose, titrating to serum concentration and response. Monitor ECG and for symptoms of toxicity.
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 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 Digoxin with Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates the interaction as major. Digoxin and Elvitegravir / cobicistat / emtricitabine / tenofovir df 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. The cobicistat component inhibits P-glycoprotein, which can raise digoxin concentrations. This may cause digoxin toxicity given its narrow therapeutic index.
How serious is the interaction between Digoxin and Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check a baseline digoxin level and begin with a lower digoxin dose, titrating to serum concentration and response. Monitor ECG and for symptoms of toxicity.
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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