Dalfopristin and Digoxin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Digoxin
Dalfopristin
No brand names on record
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
Increased digoxin levels and digoxin toxicity (nausea, vomiting, arrhythmias)
Interaction Deep Dive
The coadministration of digoxin and quinupristin/dalfopristin may result in increased serum digoxin levels1. Eubacterium lentum bacteria converts a portion of digoxin to inactive digoxin reduction products in the gut. Quinupristin/dalfopristin has been shown in vitro to have activity against Eubacterium lentum, which could result in less digoxin being metabolized and more digoxin absorbed.
Why it happens (mechanism)
Decreased digoxin metabolism by GI bacteria
Common questions
Can I take Dalfopristin and Digoxin together?
Increased digoxin levels and digoxin toxicity (nausea, vomiting, arrhythmias) Always confirm with your pharmacist or prescriber before making any change.
How serious is the Dalfopristin 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 Dalfopristin 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)
- Product Information: Synercid(R) I.V. quinupristin and dalfopristin. Rhone-Poulenc Rorer Pharmaceuticals Inc. Collegeville, PA, 1999.
Keep reading about Digoxin
Keep reading about Dalfopristin
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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