MAJOR — Use With Caution
FDA-documented dual interaction: pharmacokinetic (P-gp inhibition increases digoxin levels) plus pharmacodynamic (additive AV nodal depression). Monitor heart rate and digoxin levels.
Evidence level: STRONG
Diltiazem can increase digoxin levels in your blood AND both drugs slow electrical conduction through your heart. Together, they can cause your heart to beat dangerously slowly.
Diltiazem inhibits P-glycoprotein, increasing digoxin levels approximately 20-40%. Both drugs also have additive effects on slowing AV nodal conduction. FDA digoxin label warns about calcium channel blockers.
If taking both, your heart rate and digoxin level should be monitored. Report any dizziness, extreme fatigue, or feeling like your heart is beating very slowly.
Take Diltiazem and Digoxin as prescribed by your healthcare provider. If both are taken daily, maintain consistent timing for each. When picking up a new prescription, always ask your pharmacist to review your full medication list for timing conflicts.
Higher risk for: elderly, those with liver or kidney impairment, polypharmacy (5+ medications), recent medication changes, or those with multiple chronic conditions. Consult your pharmacist for specific risk factors.
Very slow heartbeat (below 50 bpm), dizziness, fainting, nausea, visual disturbances, extreme fatigue
Monitor digoxin levels and heart rate. May need digoxin dose reduction. ECG monitoring for AV block. Both drugs slow AV conduction — additive risk.
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.
Diltiazem can increase digoxin levels in your blood AND both drugs slow electrical conduction through your heart. Together, they can cause your heart to beat dangerously slowly.
Take Diltiazem and Digoxin as prescribed by your healthcare provider. If both are taken daily, maintain consistent timing for each. When picking up a new prescription, always ask your pharmacist to review your full medication list for timing conflicts.
Very slow heartbeat (below 50 bpm), dizziness, fainting, nausea, visual disturbances, extreme fatigue
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.
Monitor digoxin levels and heart rate. May need digoxin dose reduction. ECG monitoring for AV block. Both drugs slow AV conduction — additive risk.
Or browse the full interaction database (121,000+ pairs).