Drug interactions
Digoxin + Hydrochlorothiazide-valsartan
Severity: Moderate
Digoxin and Hydrochlorothiazide-valsartan: 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 increase the risk of digoxin toxicity and arrhythmias. Valsartan may also modestly affect digoxin handling and potassium balance, so serum digoxin and electrolytes can shift.
What this interaction means in plain words
Digoxin and Hydrochlorothiazide-valsartan 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-valsartan belongs to Cardiovascular.
Why it happens
Thiazide-induced hypokalemia and hypomagnesemia sensitize the myocardium to digoxin, and changes in renal function from ARB therapy may reduce digoxin clearance.
What to do
Monitor serum potassium, magnesium, renal function and digoxin concentrations, and keep potassium in the normal range. Reduce the digoxin dose if levels rise or signs of toxicity appear.
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-valsartan
- Aliskiren + Hydrochlorothiazide-valsartan Contraindicated
- Dofetilide + Hydrochlorothiazide-valsartan Contraindicated
- Hydrochlorothiazide-valsartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-valsartan Major
- Amifostine + Hydrochlorothiazide-valsartan Major
- Amiloride + Hydrochlorothiazide-valsartan 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-valsartan?
MediHelp rates the interaction as moderate. Digoxin and Hydrochlorothiazide-valsartan 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 increase the risk of digoxin toxicity and arrhythmias. Valsartan may also modestly affect digoxin handling and potassium balance, so serum digoxin and electrolytes can shift.
How serious is the interaction between Digoxin and Hydrochlorothiazide-valsartan?
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, renal function and digoxin concentrations, and keep potassium in the normal range. Reduce the digoxin dose if levels rise or signs of toxicity appear.
What other medicines interact with Hydrochlorothiazide-valsartan?
MediHelp also lists interactions of Hydrochlorothiazide-valsartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-valsartan page.
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