Drug interactions
Digoxin + Pacritinib
Severity: Major
Digoxin and Pacritinib: 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
Pacritinib inhibits P-glycoprotein, the efflux transporter responsible for digoxin absorption limitation and renal secretion. Digoxin concentrations may therefore rise, increasing the risk of toxicity including arrhythmias and gastrointestinal or visual symptoms.
What this interaction means in plain words
Digoxin and Pacritinib 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; Pacritinib belongs to Oncology.
Why it happens
P-glycoprotein inhibition by pacritinib increases digoxin absorption and reduces its renal and intestinal efflux.
What to do
Avoid the combination if possible; otherwise reduce the digoxin dose and monitor serum digoxin levels, ECG and renal function. Adjust the dose based on concentrations and clinical signs.
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 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 Pacritinib
- Clarithromycin + Pacritinib Contraindicated
- Ketoconazole + Pacritinib Contraindicated
- Pacritinib + Posaconazole Contraindicated
- Pacritinib + Voriconazole Contraindicated
- Amiodarone + Pacritinib Major
- Carbamazepine + Pacritinib Major
Frequently asked questions
Can I take Digoxin with Pacritinib?
MediHelp rates the interaction as major. Digoxin and Pacritinib 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. Pacritinib inhibits P-glycoprotein, the efflux transporter responsible for digoxin absorption limitation and renal secretion. Digoxin concentrations may therefore rise, increasing the risk of toxicity including arrhythmias and gastrointestinal or visual symptoms.
How serious is the interaction between Digoxin and Pacritinib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination if possible; otherwise reduce the digoxin dose and monitor serum digoxin levels, ECG and renal function. Adjust the dose based on concentrations and clinical signs.
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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