Drug interactions
Digoxin + Hydrochlorothiazide
Severity: Major
Digoxin and Hydrochlorothiazide: major 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
Thiazide-induced hypokalaemia and hypomagnesaemia sensitise the myocardium to digoxin and can precipitate arrhythmias and digoxin toxicity. This is the main concern with this combination.
What this interaction means in plain words
Digoxin and Hydrochlorothiazide 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; Hydrochlorothiazide belongs to Cardiovascular.
Why it happens
Diuretic-induced hypokalaemia and hypomagnesaemia increase myocardial sensitivity to digoxin.
What to do
Monitor potassium and magnesium and keep them in the normal range. Check digoxin levels and ECG if symptoms of toxicity appear.
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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Other interactions of Hydrochlorothiazide
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?
MediHelp rates the interaction as major. Digoxin and Hydrochlorothiazide 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. Thiazide-induced hypokalaemia and hypomagnesaemia sensitise the myocardium to digoxin and can precipitate arrhythmias and digoxin toxicity. This is the main concern with this combination.
How serious is the interaction between Digoxin and Hydrochlorothiazide?
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 potassium and magnesium and keep them in the normal range. Check digoxin levels and ECG if symptoms of toxicity appear.
What other medicines interact with Hydrochlorothiazide?
MediHelp also lists interactions of Hydrochlorothiazide with, for example, Dofetilide, Amifostine, Amiodarone. The full list is on the Hydrochlorothiazide page.
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