Drug interactions
Digoxin + Posaconazole
Severity: Major
Digoxin and Posaconazole: 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
Posaconazole has been associated with elevated digoxin concentrations, with toxicity reported (nausea, arrhythmias, visual changes). Digoxin has a narrow therapeutic index, so increases can be clinically important.
What this interaction means in plain words
Digoxin and Posaconazole 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; Posaconazole belongs to Anti Fungals.
Why it happens
Posaconazole is thought to inhibit P-glycoprotein-mediated efflux and renal clearance of digoxin.
What to do
Check digoxin levels when starting or stopping posaconazole and reduce the digoxin dose as needed. Monitor for signs of toxicity and for potassium disturbances.
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 Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole 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 Posaconazole?
MediHelp rates the interaction as major. Digoxin and Posaconazole 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. Posaconazole has been associated with elevated digoxin concentrations, with toxicity reported (nausea, arrhythmias, visual changes). Digoxin has a narrow therapeutic index, so increases can be clinically important.
How serious is the interaction between Digoxin and Posaconazole?
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 digoxin levels when starting or stopping posaconazole and reduce the digoxin dose as needed. Monitor for signs of toxicity and for potassium disturbances.
What other medicines interact with Posaconazole?
MediHelp also lists interactions of Posaconazole with, for example, Artemether, Avanafil, Cobimetinib. The full list is on the Posaconazole page.
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