Drug Interaction Report

Albuterol and Digoxin: Interaction Details

A pharmacist-reviewed analysis of the Albuterol and Digoxin interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Albuterol

ProAir Proventil Proventil® Syrup Proventil® Tablets Ventolin Ventolin® Syrup Ventolin® Tablets Volmax®
+

Digoxin

Cardoxin® Digitek Digitek® Digox Lanoxicaps® Lanoxin Lanoxin®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 16 documented Albuterol interactions, 16 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
probable
Severity
Major

What happens

Reduced digoxin exposure

Interaction Deep Dive

Concomitant use of albuterol and digoxin may cause a reduction in digoxin exposure; therefore, careful monitoring of digoxin levels is recommended3456. Measure digoxin exposure prior to initiation of concurrent use. Increase the digoxin dose by approximately 20% to 40%, if necessary, and continue monitoring digoxin exposure 12. Following single dose IV and oral administration of albuterol to healthy subjects receiving digoxin for 10 days, there was a mean decrease of 16% and 22% in serum digoxin levels, respectively. In patients with obstructive airway disease receiving chronic concomitant therapy, the clinical significance of this interaction is unclear 4.

Why it happens (mechanism)

Unknown

Literature reports

1 report — tap to read

a) Following single dose IV and oral administration of albuterol to healthy subjects receiving digoxin for 10 days, there was a mean decrease of 16% and 22% in serum digoxin levels, respectively. In patients with obstructive airway disease receiving chronic concomitant therapy, the clinical significance of this interaction is unclear 3456.

Common questions

Can I take Albuterol and Digoxin together?

Reduced digoxin exposure Always confirm with your pharmacist or prescriber before making any change.

How serious is the Albuterol and Digoxin interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

  • Does my dose of Albuterol or Digoxin need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (6)

  1. Product Information: LANOXIN(R) oral tablets, digoxin oral tablets. Concordia Pharmaceuticals Inc (per FDA), Kansas City, MO, 2019. DailyMed
  2. Product Information: DIGOXIN oral tablets, digoxin oral tablets. Aurobindo Pharma USA, Inc. (per Dailymed), East Windsor, NJ, May. DailyMed
  3. Product Information: PROAIR HFA(R) inhalation aerosol, albuterol sulfate inhalation aerosol. Teva Specialty Pharmaceuticals,LLC, Horsham, PA, 2008. DailyMed
  4. Product Information: PROVENTIL(R) HFA oral inhalation aerosol, albuterol sulfate oral inhalation aerosol. Schering Corporation, Kenilworth, NJ, 2007. DailyMed
  5. Product Information: VENTOLIN(R) HFA inhalation aerosol, albuterol sulfate HFA inhalation aerosol. GlaxoSmithKline, Research Triangle Park, NC, 2008. DailyMed
  6. Product Information: AIRSUPRA(TM) oral inhalation aerosol, albuterol budesonide oral inhalation aerosol. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2023. DailyMed
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Albuterol

Keep reading about Albuterol

All Albuterol interactions (16) Albuterol drug information
Also serious with: Levobunolol Ophthalmic Linezolid Injection Penbutolol Betaxolol
Digoxin

Keep reading about Digoxin

All Digoxin interactions (453) Digoxin drug information
Also serious with: Levoketoconazole Meclofenamate Mavorixafor Parathyroid Hormone Injection
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Albuterol + Activated Charcoal Black Tea Caffeine Cocoa Coffee Coffee Charcoal Cola Nut Ephedra + 24 more
Digoxin + Activated Charcoal Aloe Blue Flag Danshen European Buckthorn Foxglove Indian Snakeroot Lily-of-the-valley + 105 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.