Drug interactions
Digoxin + Indapamide
Severity: Major
Digoxin and Indapamide: major interaction.
Last updated Sources: UK SmPC
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
Indapamide may cause hypokalemia and hypomagnesemia, which sensitize the myocardium to digoxin and raise the risk of digoxin toxicity and arrhythmias. This is a well-recognized interaction with diuretics that deplete potassium.
What this interaction means in plain words
Digoxin and Indapamide 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; Indapamide belongs to Cardiovascular.
Why it happens
Diuretic-induced hypokalemia and hypomagnesemia increase myocardial sensitivity to digoxin, which competes with potassium at the Na+/K+-ATPase.
What to do
Monitor serum potassium, magnesium and digoxin levels, keeping potassium in the normal range. Watch for signs of digoxin toxicity such as nausea, visual changes and arrhythmias.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Digoxin and Indapamide, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
- Indapamide 2.5mg Tablets - SmPC sections 4.3/4.5 (class statement: Digitalis preparations; "Digitalis preparations:") — electronic medicines compendium (UK SmPC)
Other interactions of Indapamide
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 Indapamide?
MediHelp rates the interaction as major. Digoxin and Indapamide 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. Indapamide may cause hypokalemia and hypomagnesemia, which sensitize the myocardium to digoxin and raise the risk of digoxin toxicity and arrhythmias. This is a well-recognized interaction with diuretics that deplete potassium.
How serious is the interaction between Digoxin and Indapamide?
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 serum potassium, magnesium and digoxin levels, keeping potassium in the normal range. Watch for signs of digoxin toxicity such as nausea, visual changes and arrhythmias.
What other medicines interact with Indapamide?
MediHelp also lists interactions of Indapamide with, for example, Adagrasib, Amifostine, Amiodarone. The full list is on the Indapamide page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
