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Amiodarone + Digoxin

MAJOR — Use With Caution

FDA-documented interaction. Reduce digoxin dose by approximately 50% when starting amiodarone. Monitor digoxin levels closely.

Evidence level: STRONG

What this interaction means

Amiodarone can nearly double the amount of digoxin in your blood by slowing how your body eliminates it. Since digoxin has a very narrow safety margin, this can quickly lead to digoxin toxicity.

How it works (mechanism)

Amiodarone inhibits P-glycoprotein (P-gp) and renal tubular secretion of digoxin, increasing digoxin serum levels by 70-100%. FDA labels for both drugs document this interaction.

Practical advice

Your digoxin dose should be cut roughly in half when amiodarone is started. Get regular blood tests to check your digoxin level. Report any nausea, vision changes, or heart rhythm irregularities.

Timing

Take Digoxin and Amiodarone as prescribed by your healthcare provider. If both are taken daily, maintain consistent timing for each. Ask your pharmacist about optimal spacing — they have access to comprehensive interaction databases and can provide personalized timing guidance.

Risk factors

Renal impairment, elderly, hypokalemia, hypothyroidism

Symptoms to watch for

Nausea, vomiting, loss of appetite, visual disturbances (yellow-green halos, blurred vision), slow or irregular heartbeat, confusion, weakness

What to tell your doctor

Request digoxin dose reduction (typically 50%) when starting amiodarone. Schedule digoxin level monitoring. Discuss target digoxin therapeutic range (0.5-2.0 ng/mL, ideally 0.5-0.9).

Safer alternatives

Discuss safer alternatives with your healthcare provider. They can recommend substitutions based on your specific health goals while minimizing interaction risks. Always bring a complete list of everything you take to your appointments.

Frequently asked questions

Can I take Amiodarone and Digoxin together?

Amiodarone can nearly double the amount of digoxin in your blood by slowing how your body eliminates it. Since digoxin has a very narrow safety margin, this can quickly lead to digoxin toxicity.

When should I take Amiodarone vs Digoxin?

Take Digoxin and Amiodarone as prescribed by your healthcare provider. If both are taken daily, maintain consistent timing for each. Ask your pharmacist about optimal spacing — they have access to comprehensive interaction databases and can provide personalized timing guidance.

What symptoms should I watch for if I combine Amiodarone and Digoxin?

Nausea, vomiting, loss of appetite, visual disturbances (yellow-green halos, blurred vision), slow or irregular heartbeat, confusion, weakness

Are there safer alternatives to combining Amiodarone with Digoxin?

Discuss safer alternatives with your healthcare provider. They can recommend substitutions based on your specific health goals while minimizing interaction risks. Always bring a complete list of everything you take to your appointments.

What should I tell my doctor about taking Amiodarone and Digoxin?

Request digoxin dose reduction (typically 50%) when starting amiodarone. Schedule digoxin level monitoring. Discuss target digoxin therapeutic range (0.5-2.0 ng/mL, ideally 0.5-0.9).

Explore more interactions

Or browse the full interaction database (121,000+ pairs).