Drug interactions
Digoxin + Quinine
Severity: Major
Digoxin and Quinine: 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
Quinine can raise serum digoxin concentrations, which may lead to digoxin toxicity including nausea, visual changes and arrhythmias. The effect has been reported with quinine and quinidine.
What this interaction means in plain words
Digoxin and Quinine 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; Quinine belongs to Anti Parasitic.
Why it happens
Quinine reduces renal tubular secretion and P-glycoprotein-mediated clearance of digoxin.
What to do
Measure digoxin levels before and during quinine use and reduce the digoxin dose as needed; monitor for signs of toxicity.
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 Quinine
- Arsenic trioxide + Quinine Contraindicated
- Dofetilide + Quinine Contraindicated
- Dronedarone + Quinine Contraindicated
- Ibutilide + Quinine Contraindicated
- Mefloquine + Quinine Contraindicated
- Nilotinib + Quinine 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 Quinine?
MediHelp rates the interaction as major. Digoxin and Quinine 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. Quinine can raise serum digoxin concentrations, which may lead to digoxin toxicity including nausea, visual changes and arrhythmias. The effect has been reported with quinine and quinidine.
How serious is the interaction between Digoxin and Quinine?
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 levels before and during quinine use and reduce the digoxin dose as needed; monitor for signs of toxicity.
What other medicines interact with Quinine?
MediHelp also lists interactions of Quinine with, for example, Arsenic trioxide, Dofetilide, Dronedarone. The full list is on the Quinine page.
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