Drug interactions
Digoxin + Erythromycin lactobionate
Severity: Major
Digoxin and Erythromycin lactobionate: major interaction.
Last updated Sources: US FDA label
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
Erythromycin can raise digoxin concentrations through P-glycoprotein inhibition, and with intravenous use the gut flora effect is smaller. Digoxin toxicity has been reported with macrolides.
What this interaction means in plain words
Digoxin and Erythromycin lactobionate 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.
Digoxin belongs to Cardiovascular; Erythromycin lactobionate belongs to Anti Bacterial.
Why it happens
Erythromycin inhibits P-glycoprotein, reducing digoxin renal and intestinal efflux; gut flora effects apply mainly to oral dosing.
What to do
Monitor digoxin levels, ECG and renal function during intravenous erythromycin. Reduce the digoxin dose if levels rise.
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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References
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 Erythromycin lactobionate
- Cisapride + Erythromycin lactobionate Contraindicated
- Dihydroergotamine + Erythromycin lactobionate Contraindicated
- Dronedarone + Erythromycin lactobionate Contraindicated
- Eletriptan + Erythromycin lactobionate Contraindicated
- Ergotamine + Erythromycin lactobionate Contraindicated
- Erythromycin lactobionate + Flibanserin Contraindicated
Frequently asked questions
Can I take Digoxin with Erythromycin lactobionate?
MediHelp rates the interaction as major. Digoxin and Erythromycin lactobionate 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. Erythromycin can raise digoxin concentrations through P-glycoprotein inhibition, and with intravenous use the gut flora effect is smaller. Digoxin toxicity has been reported with macrolides.
How serious is the interaction between Digoxin and Erythromycin lactobionate?
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 digoxin levels, ECG and renal function during intravenous erythromycin. Reduce the digoxin dose if levels rise.
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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