Drug interactions
Digoxin + Propafenone
Severity: Major
Digoxin and Propafenone: 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
Propafenone raises serum digoxin concentrations, which can produce digoxin toxicity such as nausea, arrhythmias and visual disturbance. Propafenone also slows conduction, adding to the risk of bradycardia and AV block.
What this interaction means in plain words
Digoxin and Propafenone 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; Propafenone belongs to Cardiovascular.
Why it happens
Reduced renal and non-renal clearance of digoxin, possibly through P-glycoprotein inhibition, plus additive conduction effects.
What to do
Measure digoxin concentration before and after starting propafenone and reduce the digoxin dose as needed; monitor ECG.
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 Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir / ritonavir + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone Contraindicated
Frequently asked questions
Can I take Digoxin with Propafenone?
MediHelp rates the interaction as major. Digoxin and Propafenone 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. Propafenone raises serum digoxin concentrations, which can produce digoxin toxicity such as nausea, arrhythmias and visual disturbance. Propafenone also slows conduction, adding to the risk of bradycardia and AV block.
How serious is the interaction between Digoxin and Propafenone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Measure digoxin concentration before and after starting propafenone and reduce the digoxin dose as needed; monitor ECG.
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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