Drug interactions
Digoxin + Neomycin
Severity: Moderate
Digoxin and Neomycin: 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
Oral neomycin can reduce digoxin absorption, lowering serum levels and potentially reducing the effect on heart rate and heart failure. Neomycin also suppresses gut bacteria that inactivate digoxin, which in some patients could raise levels. The net effect varies, and changes may persist for days after stopping neomycin.
What this interaction means in plain words
Digoxin and Neomycin 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; Neomycin belongs to Anti Bacterial.
Why it happens
Neomycin impairs intestinal absorption of digoxin and alters gut flora that metabolise digoxin (Eubacterium lentum).
What to do
Monitor serum digoxin concentrations and clinical response during and after neomycin therapy. Adjust the digoxin dose accordingly, and consider separating doses or using a more bioavailable formulation.
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 Neomycin
- Amikacin + Neomycin Major
- Amphotericin b deoxycholate + Neomycin Major
- Capreomycin + Neomycin Major
- Cidofovir + Neomycin Major
- Colistin + Neomycin Major
- Ethacrynic acid + Neomycin Major
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 Neomycin?
MediHelp rates the interaction as moderate. Digoxin and Neomycin 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. Oral neomycin can reduce digoxin absorption, lowering serum levels and potentially reducing the effect on heart rate and heart failure. Neomycin also suppresses gut bacteria that inactivate digoxin, which in some patients could raise levels. The net effect varies, and changes may persist for days after stopping neomycin.
How serious is the interaction between Digoxin and Neomycin?
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 serum digoxin concentrations and clinical response during and after neomycin therapy. Adjust the digoxin dose accordingly, and consider separating doses or using a more bioavailable formulation.
What other medicines interact with Neomycin?
MediHelp also lists interactions of Neomycin with, for example, Amikacin, Amphotericin b deoxycholate, Capreomycin. The full list is on the Neomycin page.
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