Drug interactions
Digoxin + Quinidine
Severity: Major
Digoxin and Quinidine: 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
Quinidine typically increases serum digoxin concentrations, often about twofold, which can lead to digoxin toxicity including nausea, visual changes, bradycardia and arrhythmias. Quinidine can also have additional effects on cardiac conduction.
What this interaction means in plain words
Digoxin and Quinidine 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; Quinidine belongs to Anti Parasitic.
Why it happens
Quinidine inhibits P-glycoprotein and reduces renal tubular secretion of digoxin.
What to do
Reduce the digoxin dose by about half when starting quinidine, or consider an alternative. Monitor digoxin levels, ECG and potassium.
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 Quinidine
- Adagrasib + Quinidine Contraindicated
- Arsenic trioxide + Quinidine Contraindicated
- Artemether / lumefantrine + Quinidine Contraindicated
- Chloroquine + Quinidine Contraindicated
- Dofetilide + Quinidine Contraindicated
- Dronedarone + Quinidine 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 Quinidine?
MediHelp rates the interaction as major. Digoxin and Quinidine 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. Quinidine typically increases serum digoxin concentrations, often about twofold, which can lead to digoxin toxicity including nausea, visual changes, bradycardia and arrhythmias. Quinidine can also have additional effects on cardiac conduction.
How serious is the interaction between Digoxin and Quinidine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the digoxin dose by about half when starting quinidine, or consider an alternative. Monitor digoxin levels, ECG and potassium.
What other medicines interact with Quinidine?
MediHelp also lists interactions of Quinidine with, for example, Adagrasib, Arsenic trioxide, Artemether / lumefantrine. The full list is on the Quinidine page.
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