Drug Interaction Report

Digoxin and Dronedarone: Interaction Details

A pharmacist-reviewed analysis of the Digoxin and Dronedarone 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

Dronedarone

Multaq
+

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
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
unspecified
Evidence
established
Severity
Major

What happens

Increased digoxin exposure and increased conduction effects of dronedarone

Interaction Deep Dive

Coadministration of digoxin and dronedarone (P-gp inhibitor) may increase digoxin exposure. Measure digoxin exposure before initiating concomitant drugs. Reduce digoxin exposure by decreasing dose by approximately 30-50% or by modifying the dosing frequency and continue monitoring12 or consider discontinuing digoxin with initiation of dronedarone 4. Also, monitor potential signs and symptoms of clinical toxicity is necessary when initiating, adjusting, or discontinuing dronedarone. Sudden death was more common in patients receiving digoxin with dronedarone than on either alone. It is not clear whether this represents an interaction or is related to the presence of advanced heart disease, a known risk factor for sudden death in patients receiving digoxin 3. Digoxin can potentiate the electrophysiologic effects of dronedarone (such as decreased AV-node conduction) 4.

Why it happens (mechanism)

Inhibition of P-gp mediated efflux transport of digoxin; potentiation of dronedarone electrophysiologic effects

Literature reports

1 report — tap to read

a) During pharmacokinetic studies, coadministration of dronedarone and oral digoxin resulted in a 150% increase in digoxin AUC 12.

Common questions

Can I take Digoxin and Dronedarone together?

Increased digoxin exposure and increased conduction effects of dronedarone Always confirm with your pharmacist or prescriber before making any change.

How serious is the Digoxin and Dronedarone 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 strong is the evidence for this interaction?

The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.

Questions for your pharmacist

  • Does my dose of Digoxin or Dronedarone 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 (4)

  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: DIGOXIN intravenous injection, digoxin intravenous injection. Hikma Pharmaceuticals USA Inc. (per Dailymed), Berkeley Heights, NJ, 2023. DailyMed
  4. Product Information: MULTAQ(R) oral tablets, dronedarone oral tablets. sanofi-aventis US LLC (per manufacturer), Bridgewater, NJ, 2017. DailyMed
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Dronedarone

Keep reading about Dronedarone

All Dronedarone interactions (146)
Also serious with: Octreotide Injection Ofloxacin Otic Cyclosporine Ophthalmic Relugolix
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:

Dronedarone + Activated Charcoal American Hellebore Arsenic Beer Cesium Ephedra Grapefruit Siberian Cocklebur + 195 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.