Drug interactions
Digoxin + Flecainide
Severity: Moderate
Digoxin and Flecainide: 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
Flecainide can modestly raise serum digoxin concentrations, and both drugs slow cardiac conduction. Together they may increase the risk of bradycardia, AV block and proarrhythmia, especially in structural heart disease. Flecainide is also unsuitable in many patients who need digoxin.
What this interaction means in plain words
Digoxin and Flecainide 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.
Digoxin belongs to Cardiovascular; Flecainide belongs to Cardiovascular.
Why it happens
Possible reduced digoxin clearance plus additive effects on cardiac conduction; the pharmacokinetic mechanism is not fully established.
What to do
Monitor digoxin concentrations, ECG and heart rate when starting or changing flecainide, and reduce digoxin dose if levels rise.
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 Flecainide
- Flecainide + Nirmatrelvir Contraindicated
- Flecainide + Nirmatrelvir / ritonavir Contraindicated
- Flecainide + Pimozide Contraindicated
- Flecainide + Ritonavir Contraindicated
- Flecainide + Thioridazine Contraindicated
- Flecainide + Tipranavir Contraindicated
Frequently asked questions
Can I take Digoxin with Flecainide?
MediHelp rates the interaction as moderate. Digoxin and Flecainide 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. Flecainide can modestly raise serum digoxin concentrations, and both drugs slow cardiac conduction. Together they may increase the risk of bradycardia, AV block and proarrhythmia, especially in structural heart disease. Flecainide is also unsuitable in many patients who need digoxin.
How serious is the interaction between Digoxin and Flecainide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor digoxin concentrations, ECG and heart rate when starting or changing flecainide, and reduce 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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