Drug interactions
Digoxin + Hydrochlorothiazide-irbesartan
Severity: Moderate
Digoxin and Hydrochlorothiazide-irbesartan: 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
Hydrochlorothiazide can cause hypokalemia and hypomagnesemia, which sensitize the heart to digoxin and increase the risk of digoxin-related arrhythmias. Irbesartan may raise potassium and renal function changes can alter digoxin levels, so electrolyte and drug levels can shift in either direction.
What this interaction means in plain words
Digoxin and Hydrochlorothiazide-irbesartan 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; Hydrochlorothiazide-irbesartan belongs to Cardiovascular.
Why it happens
Diuretic-induced hypokalemia and hypomagnesemia increase myocardial sensitivity to digoxin, with additional effects of ARB on potassium and renal function.
What to do
Monitor serum potassium, magnesium and renal function, and check digoxin concentration if toxicity is suspected. Keep potassium in the normal range.
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 Hydrochlorothiazide-irbesartan
- Aliskiren + Hydrochlorothiazide-irbesartan Contraindicated
- Dofetilide + Hydrochlorothiazide-irbesartan Contraindicated
- Hydrochlorothiazide-irbesartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-irbesartan Major
- Amifostine + Hydrochlorothiazide-irbesartan Major
- Amiloride + Hydrochlorothiazide-irbesartan Major
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 Hydrochlorothiazide-irbesartan?
MediHelp rates the interaction as moderate. Digoxin and Hydrochlorothiazide-irbesartan 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. Hydrochlorothiazide can cause hypokalemia and hypomagnesemia, which sensitize the heart to digoxin and increase the risk of digoxin-related arrhythmias. Irbesartan may raise potassium and renal function changes can alter digoxin levels, so electrolyte and drug levels can shift in either direction.
How serious is the interaction between Digoxin and Hydrochlorothiazide-irbesartan?
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 serum potassium, magnesium and renal function, and check digoxin concentration if toxicity is suspected. Keep potassium in the normal range.
What other medicines interact with Hydrochlorothiazide-irbesartan?
MediHelp also lists interactions of Hydrochlorothiazide-irbesartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-irbesartan page.
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