Drug interactions
Digoxin + Tolfenamic acid
Severity: Moderate
Digoxin and Tolfenamic acid: 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
NSAIDs such as tolfenamic acid can reduce renal function and raise digoxin concentrations, particularly in older patients or those with renal impairment. They can also cause fluid retention that worsens heart failure.
What this interaction means in plain words
Digoxin and Tolfenamic acid 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; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
NSAIDs reduce renal prostaglandin-mediated blood flow and glomerular filtration, decreasing renal digoxin clearance.
What to do
Monitor renal function and serum digoxin levels if the combination is needed. Consider an alternative analgesic such as paracetamol.
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 Tolfenamic acid
Frequently asked questions
Can I take Digoxin with Tolfenamic acid?
MediHelp rates the interaction as moderate. Digoxin and Tolfenamic acid 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. NSAIDs such as tolfenamic acid can reduce renal function and raise digoxin concentrations, particularly in older patients or those with renal impairment. They can also cause fluid retention that worsens heart failure.
How serious is the interaction between Digoxin and Tolfenamic acid?
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 renal function and serum digoxin levels if the combination is needed. Consider an alternative analgesic such as paracetamol.
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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