Drug interactions
Digoxin + Roxithromycin
Severity: Major
Digoxin and Roxithromycin: major 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
Macrolides can raise digoxin levels and cause toxicity, particularly in older patients or those with renal impairment. Effect is seen within days of starting the antibiotic.
What this interaction means in plain words
Digoxin and Roxithromycin 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; Roxithromycin belongs to Anti Bacterial.
Why it happens
Inhibition of intestinal P-glycoprotein and loss of gut flora that inactivate digoxin (Eubacterium lentum) increase digoxin absorption.
What to do
Monitor digoxin concentration and signs of toxicity, and reduce digoxin dose if needed; consider a non-macrolide antibiotic.
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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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 Roxithromycin
- Argatroban + Roxithromycin Moderate
- Cyclosporin + Roxithromycin Moderate
- Roxithromycin + Tacrolimus Moderate
- Ampicillin-sulbactam + Roxithromycin Minor
- Ampicillin + Roxithromycin Minor
- Balsalazide + Roxithromycin Minor
Frequently asked questions
Can I take Digoxin with Roxithromycin?
MediHelp rates the interaction as major. Digoxin and Roxithromycin 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. Macrolides can raise digoxin levels and cause toxicity, particularly in older patients or those with renal impairment. Effect is seen within days of starting the antibiotic.
How serious is the interaction between Digoxin and Roxithromycin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor digoxin concentration and signs of toxicity, and reduce digoxin dose if needed; consider a non-macrolide antibiotic.
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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