Drug interactions
Digoxin + Sirolimus
Severity: Moderate
Digoxin and Sirolimus: 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
Sirolimus may increase digoxin concentrations and the risk of digoxin toxicity. The effect is variable and is mainly a concern because digoxin has a narrow therapeutic index.
What this interaction means in plain words
Digoxin and Sirolimus 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.
Digoxin belongs to Cardiovascular; Sirolimus belongs to Miscellaneous.
Why it happens
Sirolimus inhibits P-glycoprotein, reducing digoxin efflux and renal and intestinal clearance.
What to do
Monitor serum digoxin levels, renal function and ECG when starting or adjusting sirolimus. Reduce the digoxin dose if concentrations rise.
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
Other interactions of Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus Contraindicated
Frequently asked questions
Can I take Digoxin with Sirolimus?
MediHelp rates the interaction as moderate. Digoxin and Sirolimus 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. Sirolimus may increase digoxin concentrations and the risk of digoxin toxicity. The effect is variable and is mainly a concern because digoxin has a narrow therapeutic index.
How serious is the interaction between Digoxin and Sirolimus?
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 serum digoxin levels, renal function and ECG when starting or adjusting sirolimus. Reduce the digoxin dose if concentrations rise.
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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