Drug Interaction Report

Digoxin and Carvedilol: Interaction Details

A pharmacist-reviewed analysis of the Digoxin and Carvedilol 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

Digoxin

Cardoxin® Digitek Digitek® Digox Lanoxicaps® Lanoxin Lanoxin®
+

Carvedilol

Coreg Coreg® Coreg® CR
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 453 documented Digoxin interactions, 359 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
rapid
Evidence
theoretical
Severity
Major

What happens

Increased digoxin exposure and an increased risk of bradycardia and advanced or complete heart block

Interaction Deep Dive

Coadministration of digoxin and carvedilol (P-gp inhibitor and beta blocker) may increase digoxin exposure, may also have additive effects on AV node conduction and increase the risk of bradycardia and advanced or complete heart block. Measure digoxin exposure prior to initiation of concurrent use. Reduce the oral digoxin dose by approximately 15% to 30% or modify the dosing frequency. Continue monitoring digoxin exposure. Also, monitor potential signs and symptoms of clinical toxicity is necessary12, especially when initiating, adjusting, or discontinuing carvedilol 3.

Why it happens (mechanism)

Inhibition of P-gp mediated efflux transport of digoxin; additive effects on AV node conduction

Literature reports

1 report — tap to read

a) During pharmacokinetic studies of patients with hypertension (n=12), coadministration of carvedilol 25 mg and digoxin 0.25 mg once daily for 14 days resulted in a 16% increase in digoxin serum trough concentrations and a 14% increase in digoxin AUC at steady state 3.

Common questions

Can I take Digoxin and Carvedilol together?

Increased digoxin exposure and an increased risk of bradycardia and advanced or complete heart block Always confirm with your pharmacist or prescriber before making any change.

How serious is the Digoxin and Carvedilol interaction?

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

How quickly could this interaction happen?

The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.

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 Digoxin or Carvedilol 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 (3)

  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: COREG(TM) oral tablets, carvedilol oral tablets. GlaxoSmithKline (per FDA), Research Triangle Park, NC, 2017. DailyMed
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Digoxin

Keep reading about Digoxin

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

Keep reading about Carvedilol

All Carvedilol interactions (82) Carvedilol drug information
Also serious with: Colchicine Olodaterol Oral Inhalation Miconazole Vaginal Abiraterone
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:

Digoxin + Activated Charcoal Aloe Blue Flag Danshen European Buckthorn Foxglove Indian Snakeroot Lily-of-the-valley + 105 more
Carvedilol + Activated Charcoal American Hellebore American Mistletoe Grapefruit Indian Snakeroot Tyramine 1,3-dmaa Acacia Rigidula + 203 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.