Drug interactions
Digoxin + Trimethoprim
Severity: Moderate
Digoxin and Trimethoprim: 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
Trimethoprim can raise serum digoxin concentrations and digoxin may in turn modestly raise trimethoprim exposure. Increased digoxin levels may cause nausea, arrhythmias or other signs of toxicity, especially in older patients or those with renal impairment.
What this interaction means in plain words
Digoxin and Trimethoprim 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; Trimethoprim belongs to Anti Bacterial.
Why it happens
Trimethoprim may reduce renal tubular secretion of digoxin and possibly alter gut flora that metabolize digoxin, while both drugs compete for renal tubular cationic secretion.
What to do
Monitor serum digoxin concentrations, renal function and electrolytes when trimethoprim is started or stopped. Reduce the digoxin dose if levels rise or toxicity signs appear.
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 Trimethoprim
Frequently asked questions
Can I take Digoxin with Trimethoprim?
MediHelp rates the interaction as moderate. Digoxin and Trimethoprim 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. Trimethoprim can raise serum digoxin concentrations and digoxin may in turn modestly raise trimethoprim exposure. Increased digoxin levels may cause nausea, arrhythmias or other signs of toxicity, especially in older patients or those with renal impairment.
How serious is the interaction between Digoxin and Trimethoprim?
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 concentrations, renal function and electrolytes when trimethoprim is started or stopped. Reduce the digoxin dose if levels rise or toxicity signs appear.
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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