Amiloride and Digoxin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Amiloride
No brand names on recordDigoxin
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.
What happens
Decreased digoxin effectiveness
Interaction Deep Dive
Although concurrent administration of amiloride increased renal clearance and reduced nonrenal clearance of digoxin, there was minimal net effect on digoxin plasma levels1. The most significant effect was a reduction in the positive inotropic effect of digoxin.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) Concomitant amiloride and digoxin therapy produced a slight increase in serum digoxin levels in 6 healthy individuals administered amiloride 10 mg daily for 8 days. The interaction was felt to result from altered digoxin elimination, increased renal tubular secretion of digoxin, and reduced extrarenal digoxin clearance. Patients experienced a reduction in the inotropic effect of digoxin 1. The significance of this interaction, especially in congestive heart failure patients, is unknown. Until further data are available, patients receiving concurrent digoxin and amiloride therapy should be monitored for altered digoxin response.
Common questions
Can I take Amiloride and Digoxin together?
Decreased digoxin effectiveness Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amiloride and Digoxin interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Amiloride 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 anything you'd monitor while I'm on both?
References (1)
- Waldorff S, Hansen B, Kjaergard H, et al: Amiloride-induced changes in digoxin dynamics and kinetics: abolition of digoxin-induced inotropism with amiloride. Clin Pharmacol Ther 1981; 30:172-176. PubMed
Keep reading about Amiloride
Keep reading about Digoxin
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:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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