Drug interactions
Digoxin + Itraconazole
Severity: Major
Digoxin and Itraconazole: major interaction.
Last updated Sources: US FDA label
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
Itraconazole increases digoxin concentrations and can precipitate digoxin toxicity, with nausea, visual disturbance and arrhythmias. The risk is greater in renal impairment and in the elderly.
What this interaction means in plain words
Digoxin and Itraconazole 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; Itraconazole belongs to Anti Fungals.
Why it happens
Itraconazole inhibits P-glycoprotein, reducing renal and intestinal efflux of digoxin.
What to do
Check the digoxin level before starting itraconazole and reduce the digoxin dose preemptively. Monitor serum levels, potassium and ECG, and adjust after itraconazole is stopped.
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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References
Other interactions of Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
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 Itraconazole?
MediHelp rates the interaction as major. Digoxin and Itraconazole 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. Itraconazole increases digoxin concentrations and can precipitate digoxin toxicity, with nausea, visual disturbance and arrhythmias. The risk is greater in renal impairment and in the elderly.
How serious is the interaction between Digoxin and Itraconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check the digoxin level before starting itraconazole and reduce the digoxin dose preemptively. Monitor serum levels, potassium and ECG, and adjust after itraconazole is stopped.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
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