Digoxin and Albuterol Oral Inhalation: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Albuterol Oral Inhalation
Digoxin
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.
You've been prescribed albuterol (your rescue inhaler) along with digoxin (a heart medicine). Studies have shown that albuterol can slightly lower the amount of digoxin in your blood, by roughly 16% to 22% in one study. Digoxin is a medication where even small changes in blood level can matter, so a lower level could mean it doesn't work quite as well for your heart.
The good news is this is very manageable. Your care team can check your digoxin blood level and adjust your dose if needed. Please keep taking both medicines as prescribed, and just let your doctor or pharmacist know you're using both so they can monitor you.
Effect: Reduced digoxin exposure with concurrent albuterol. In healthy subjects on digoxin for 10 days, single-dose IV and oral albuterol produced mean serum digoxin decreases of 16% and 22%, respectively.
- Direction: Decreased digoxin serum concentrations (potential reduced therapeutic effect).
- Mechanism: Unknown.
- Evidence: Probable; severity major. Clinical significance in chronic obstructive airway disease patients is unclear.
- NTI consideration: Digoxin is narrow therapeutic index, so even modest reductions warrant attention.
Management: Measure digoxin level before starting concurrent therapy, monitor levels during co-administration, and increase the digoxin dose by approximately 20% to 40% if clinically indicated.
What happens
Reduced digoxin exposure
Interaction Deep Dive
Taking albuterol together with digoxin can lower digoxin exposure, so digoxin levels should be watched closely4213. Obtain a measurement of digoxin exposure before starting the two drugs together. If needed, raise the digoxin dose by roughly 20% to 40% and keep tracking digoxin exposure56. When albuterol was given as single IV and oral doses to healthy subjects who had been receiving digoxin for 10 days, serum digoxin concentrations fell by an average of 16% and 22%, respectively. For patients who have obstructive airway disease and are on ongoing combined therapy, it remains uncertain what clinical importance this interaction holds2.
Why it happens (mechanism)
Unknown
How to manage this interaction
This interaction is manageable with monitoring and dose tailoring by your care team.
- Keep taking both medications exactly as prescribed unless your doctor tells you otherwise.
- Your team will typically check your digoxin blood level before and during combined use.
- If your level drops, your digoxin dose may be adjusted upward (roughly 20% to 40%) and individualized by your care team, with continued monitoring.
- Tell your pharmacist or prescriber that you use both, and report any symptoms your heart medicine is meant to control seeming worse.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) After a single intravenous and oral dose of albuterol was given to healthy volunteers who had been taking digoxin for 10 days, serum digoxin concentrations fell by a mean of 16% and 22%, respectively. Among patients with obstructive airway disease who are on chronic concurrent therapy, the clinical relevance of this interaction remains uncertain 4213.
Common questions
Can I take Digoxin and Albuterol Oral Inhalation together?
Albuterol can modestly lower digoxin blood levels, so your care team may check your digoxin level and adjust the dose if needed. Keep taking both as prescribed and let your pharmacist or doctor know you use both. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Digoxin and Albuterol Oral Inhalation 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 is the Digoxin and Albuterol Oral Inhalation interaction managed?
This interaction is manageable with monitoring and dose tailoring by your care team. Keep taking both medications exactly as prescribed unless your doctor tells you otherwise. Your team will typically check your digoxin blood level before and during combined use. If your level drops, your digoxin dose may be adjusted upward (roughly 20% to 40%) and individualized by your care team, with continued… Management is individual — always follow your own care team's guidance.
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 Digoxin or Albuterol Oral Inhalation 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)
- Product Information: VENTOLIN(R) HFA inhalation aerosol, albuterol sulfate HFA inhalation aerosol. GlaxoSmithKline, Research Triangle Park, NC, 2008. DailyMed
- Product Information: PROVENTIL(R) HFA oral inhalation aerosol, albuterol sulfate oral inhalation aerosol. Schering Corporation, Kenilworth, NJ, 2007. DailyMed
- Product Information: AIRSUPRA(TM) oral inhalation aerosol, albuterol budesonide oral inhalation aerosol. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2023. DailyMed
- Product Information: PROAIR HFA(R) inhalation aerosol, albuterol sulfate inhalation aerosol. Teva Specialty Pharmaceuticals,LLC, Horsham, PA, 2008. DailyMed
- Product Information: LANOXIN(R) oral tablets, digoxin oral tablets. Concordia Pharmaceuticals Inc (per FDA), Kansas City, MO, 2019. DailyMed
- Product Information: DIGOXIN oral tablets, digoxin oral tablets. Aurobindo Pharma USA, Inc. (per Dailymed), East Windsor, NJ, May. DailyMed
Keep reading about Albuterol Oral Inhalation
Keep reading about Digoxin
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