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Interazioni tra farmaci

Digoxin + Furosemide

Gravità: Maggiore

Digoxin and Furosemide: major interaction.

Ultimo aggiornamento Fonti: US FDA label

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Sintesi

Furosemide can cause hypokalemia and hypomagnesemia, which markedly increase myocardial sensitivity to digoxin and the risk of arrhythmias even at normal serum digoxin concentrations. Volume depletion and reduced renal function from diuresis may also reduce digoxin clearance. The combination is very common in heart failure, so electrolyte monitoring is essential.

Cosa significa questa interazione in parole semplici

Digoxin and Furosemide 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; Furosemide belongs to Cardiovascular.

Livello di evidenza: High

Perché avviene

Pharmacodynamic: loop diuretic-induced potassium and magnesium depletion potentiates digoxin's effects on cardiac automaticity and conduction. Pharmacokinetic: volume depletion or acute kidney injury can reduce renal digoxin clearance.

Cosa fare

Check potassium, magnesium and creatinine at baseline, after starting or changing the furosemide dose, and periodically thereafter. Correct deficits, using potassium supplements, a potassium-sparing diuretic, an ACE inhibitor or an MRA where appropriate.

Cosa chiedere al farmacista

  • 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Riferimenti

Domande frequenti

Can I take Digoxin with Furosemide?

MediHelp rates the interaction as major. Digoxin and Furosemide 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. Furosemide can cause hypokalemia and hypomagnesemia, which markedly increase myocardial sensitivity to digoxin and the risk of arrhythmias even at normal serum digoxin concentrations. Volume depletion and reduced renal function from diuresis may also reduce digoxin clearance. The combination is very common in heart failure, so electrolyte monitoring is essential.

How serious is the interaction between Digoxin and Furosemide?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check potassium, magnesium and creatinine at baseline, after starting or changing the furosemide dose, and periodically thereafter. Correct deficits, using potassium supplements, a potassium-sparing diuretic, an ACE inhibitor or an MRA where appropriate.

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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