Drug interactions
Digoxin + Mirabegron
Severity: Major
Digoxin and Mirabegron: 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
Mirabegron inhibits intestinal and renal P-glycoprotein, which increases digoxin exposure. Because digoxin has a narrow therapeutic index, toxicity such as arrhythmia, nausea and visual disturbance can result.
What this interaction means in plain words
Digoxin and Mirabegron 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; Mirabegron belongs to Genitourinary.
Why it happens
Mirabegron inhibits P-glycoprotein, increasing digoxin absorption and reducing its renal elimination.
What to do
Start digoxin at the lowest dose when mirabegron is already used, and titrate to serum levels and clinical response. Monitor digoxin concentrations when either drug is started or 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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Other interactions of Mirabegron
- Flecainide + Mirabegron Major
- Mirabegron + Propafenone Major
- Mirabegron + Thioridazine Major
- Amitriptyline + Mirabegron Moderate
- Amoxapine + Mirabegron Moderate
- Atomoxetine + Mirabegron Moderate
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 Mirabegron?
MediHelp rates the interaction as major. Digoxin and Mirabegron 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. Mirabegron inhibits intestinal and renal P-glycoprotein, which increases digoxin exposure. Because digoxin has a narrow therapeutic index, toxicity such as arrhythmia, nausea and visual disturbance can result.
How serious is the interaction between Digoxin and Mirabegron?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start digoxin at the lowest dose when mirabegron is already used, and titrate to serum levels and clinical response. Monitor digoxin concentrations when either drug is started or stopped.
What other medicines interact with Mirabegron?
MediHelp also lists interactions of Mirabegron with, for example, Flecainide, Propafenone, Thioridazine. The full list is on the Mirabegron page.
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