Drug interactions
Digoxin + Venetoclax
Severity: Major
Digoxin and Venetoclax: major interaction.
Last updated Sources: UK SmPC
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
Venetoclax inhibits P-glycoprotein and can increase exposure to P-gp substrates such as digoxin, especially in the gut. This may lead to digoxin toxicity given its narrow therapeutic index.
What this interaction means in plain words
Digoxin and Venetoclax 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; Venetoclax belongs to Miscellaneous.
Why it happens
P-glycoprotein inhibition by venetoclax increases intestinal absorption and reduces efflux of digoxin.
What to do
If coadministration is required, give digoxin at least 6 hours before venetoclax and monitor serum digoxin levels and ECG. Reduce the digoxin dose if concentrations rise.
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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References
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 Venetoclax
- Clarithromycin + Venetoclax Contraindicated
- Itraconazole + Venetoclax Contraindicated
- Ketoconazole + Venetoclax Contraindicated
- Posaconazole + Venetoclax Contraindicated
- Venetoclax + Voriconazole Contraindicated
- Amiodarone + Venetoclax Major
Frequently asked questions
Can I take Digoxin with Venetoclax?
MediHelp rates the interaction as major. Digoxin and Venetoclax 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. Venetoclax inhibits P-glycoprotein and can increase exposure to P-gp substrates such as digoxin, especially in the gut. This may lead to digoxin toxicity given its narrow therapeutic index.
How serious is the interaction between Digoxin and Venetoclax?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: If coadministration is required, give digoxin at least 6 hours before venetoclax and monitor serum digoxin levels and ECG. 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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