Drug interactions
Digoxin + Rifampin
Severity: Moderate
Digoxin and Rifampin: moderate interaction.
Last updated
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
Rifampin lowers digoxin serum concentrations, particularly after oral dosing, and can cause loss of heart rate or heart failure control. The effect develops over days and reverses after rifampin is stopped, when digoxin toxicity may emerge.
What this interaction means in plain words
Digoxin and Rifampin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Rifampin induces intestinal and renal P-glycoprotein, reducing digoxin absorption and increasing its elimination.
What to do
Monitor digoxin concentrations and clinical response, and increase the digoxin dose if needed. Reassess the dose when rifampin is discontinued.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Rifampin?
MediHelp rates the interaction as moderate. Digoxin and Rifampin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Rifampin lowers digoxin serum concentrations, particularly after oral dosing, and can cause loss of heart rate or heart failure control. The effect develops over days and reverses after rifampin is stopped, when digoxin toxicity may emerge.
How serious is the interaction between Digoxin and Rifampin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor digoxin concentrations and clinical response, and increase the digoxin dose if needed. Reassess the dose when rifampin is discontinued.
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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