Drug interactions
Digoxin + Glecaprevir / pibrentasvir
Severity: Moderate
Digoxin and Glecaprevir / pibrentasvir: 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
Glecaprevir and pibrentasvir inhibit intestinal P-glycoprotein, which can raise digoxin exposure. Because digoxin has a narrow therapeutic index, higher levels can cause nausea, visual disturbances and dangerous arrhythmias.
What this interaction means in plain words
Digoxin and Glecaprevir / pibrentasvir 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.
Why it happens
Inhibition of P-glycoprotein-mediated efflux increases digoxin absorption and reduces its renal and intestinal elimination.
What to do
Measure serum digoxin before starting the antiviral combination and reduce the digoxin dose by about half or lengthen the interval as labeling suggests. Continue monitoring digoxin concentrations and for signs of toxicity.
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
Frequently asked questions
Can I take Digoxin with Glecaprevir / pibrentasvir?
MediHelp rates the interaction as moderate. Digoxin and Glecaprevir / pibrentasvir 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. Glecaprevir and pibrentasvir inhibit intestinal P-glycoprotein, which can raise digoxin exposure. Because digoxin has a narrow therapeutic index, higher levels can cause nausea, visual disturbances and dangerous arrhythmias.
How serious is the interaction between Digoxin and Glecaprevir / pibrentasvir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Measure serum digoxin before starting the antiviral combination and reduce the digoxin dose by about half or lengthen the interval as labeling suggests. Continue monitoring digoxin concentrations and for signs 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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