Drug interactions
Digoxin + Tolvaptan
Severity: Moderate
Digoxin and Tolvaptan: 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
Tolvaptan can raise digoxin concentrations modestly, increasing the risk of toxicity. Changes in sodium and potassium during tolvaptan therapy may also affect digoxin sensitivity.
What this interaction means in plain words
Digoxin and Tolvaptan 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; Tolvaptan belongs to Endocrine.
Why it happens
Tolvaptan inhibits P-glycoprotein, decreasing digoxin efflux and clearance.
What to do
Monitor serum digoxin levels, potassium and sodium when starting tolvaptan. Reduce the digoxin dose if levels are high or toxicity appears.
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 Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Digoxin with Tolvaptan?
MediHelp rates the interaction as moderate. Digoxin and Tolvaptan 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. Tolvaptan can raise digoxin concentrations modestly, increasing the risk of toxicity. Changes in sodium and potassium during tolvaptan therapy may also affect digoxin sensitivity.
How serious is the interaction between Digoxin and Tolvaptan?
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, potassium and sodium when starting tolvaptan. Reduce the digoxin dose if levels are high or toxicity appears.
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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