Drug interactions
Digoxin + Midodrine
Severity: Moderate
Digoxin and Midodrine: 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
Midodrine's active metabolite is secreted by renal tubular cation transport, so competition with digoxin is theoretically possible. However, midodrine can also cause reflex bradycardia, which may add to the effects of digoxin on heart rate and conduction.
What this interaction means in plain words
Digoxin and Midodrine 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; Midodrine belongs to Miscellaneous.
Why it happens
Additive bradycardic effect through reflex vagal response; theoretical competition for renal tubular secretion.
What to do
Monitor heart rate and ECG, and check digoxin levels if bradycardia or signs of toxicity develop.
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 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
Other interactions of Midodrine
- Isocarboxazid + Midodrine Contraindicated
- Midodrine + Phenelzine Contraindicated
- Midodrine + Tranylcypromine Contraindicated
- Dextroamphetamine + Midodrine Major
- Dihydroergotamine intranasal + Midodrine Major
- Dihydroergotamine + Midodrine Major
Frequently asked questions
Can I take Digoxin with Midodrine?
MediHelp rates the interaction as moderate. Digoxin and Midodrine 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. Midodrine's active metabolite is secreted by renal tubular cation transport, so competition with digoxin is theoretically possible. However, midodrine can also cause reflex bradycardia, which may add to the effects of digoxin on heart rate and conduction.
How serious is the interaction between Digoxin and Midodrine?
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 heart rate and ECG, and check digoxin levels if bradycardia or signs of toxicity develop.
What other medicines interact with Digoxin?
MediHelp also lists interactions of Digoxin with, for example, Lily of the valley, Squill, Adagrasib. The full list is on the Digoxin page.
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