Drug Interaction Report

Bumetanide and Digoxin: Interaction Details

A pharmacist-reviewed analysis of the Bumetanide 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

Bumetanide

Bumex Enbumyst
+

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
Moderate
Can be significant — usually manageable with 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 55 documented Bumetanide interactions, 12 are rated moderate — including this one.
Onset
delayed
Evidence
theoretical
Severity
Moderate

What happens

Increased risk of digoxin toxicity (nausea, vomiting, cardiac arrhythmias)

Interaction Deep Dive

Concomitant furosemide and digitalis therapy can result in digitalis toxicity secondary to hypokalemia and possibly hypomagnesemia1235467.

Why it happens (mechanism)

Potassium and magnesium loss may enhance the effect of digoxin

Common questions

Can I take Bumetanide and Digoxin together?

Increased risk of digoxin toxicity (nausea, vomiting, cardiac arrhythmias) Always confirm with your pharmacist or prescriber before making any change.

How serious is the Bumetanide 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.

Questions for your pharmacist

  • Does my dose of Bumetanide 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 (7)

  1. Tannen RL: Diuretic-induced hypokalemia (clinical conference). Kidney Int 1985; 28:988-1000. PubMed
  2. Whang R, Oei TO, & Watanabe A: Frequency of hypomagnesemia in hospitalized patients receiving digitalis. Arch Intern Med 1985; 145:655-656. DOI
  3. Knochel JP: Diuretic-induced hypokalemia. Am J Med 1984; 77:18-27. PubMed
  4. Sandor FF, Pickens PT, & Crallan J: Variations of plasma potassium concentrations during long-term treatment of hypertension with diuretics without potassium supplements. Br Med J 1982; 284:711-715. PubMed
  5. Iseri LT, Freed J, & Bures AR: Magnesium deficiency and cardiac disorders. Am J Med 1975; 58:837-846. DOI
  6. Steiness E & Olesen KH: Cardiac arrhythmias induced by hypokalemia and potassium loss during maintenance digoxin therapy. Br Heart J 1976; 38:167-172.
  7. Shapiro S, Slone D, Lewis GP, et al: The epidemiology of digoxin. A study in three Boston hospitals. J Chron Dis 1969; 22:361-371. DOI
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Bumetanide

Keep reading about Bumetanide

All Bumetanide interactions (55)
Also serious with: Desmopressin Nasal Acetaminophen And Codeine Morphine Injection Gentamicin Ophthalmic
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:

Bumetanide + Activated Charcoal American Hellebore American Mistletoe Lithium Oleander Tyramine Yellow Dock Abuta + 210 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.