Drug Interaction Report

Digoxin and Kaolin: Interaction Details

A pharmacist-reviewed analysis of the Digoxin and Kaolin 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®
+

Kaolin

Pet Pectillin
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

Reduced digoxin exposure

Interaction Deep Dive

Coadministration of digoxin and kaolin may reduce digoxin exposure12. Commonly used anti-diarrheal products containing kaolin have been demonstrated to reduce the absorption of digoxin tablets by 20% to 62% 34. Measure digoxin exposure prior to initiation of concurrent use. Increase the digoxin dose by approximately 20% to 40%, if necessary, and continue monitoring exposure 12.

Why it happens (mechanism)

Altered absorption of digoxin

Literature reports

1 report — tap to read

a) Commonly used anti-diarrheal products containing kaolin have been demonstrated to reduce the absorption of digoxin tablets by 20% to 62% 34.

Common questions

Can I take Digoxin and Kaolin together?

Reduced digoxin exposure Always confirm with your pharmacist or prescriber before making any change.

How serious is the Digoxin and Kaolin 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.

Questions for your pharmacist

  • Does my dose of Digoxin or Kaolin 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. Rodin SM & Johnson BF: Pharmacokinetic interactions with digoxin. Clin Pharmacokinet 1988; 15:227-244. PubMed
  4. Albert KS, Elliot WJ, Abbott RD, et al: Influence of kaolin-pectin suspension on steady-state plasma digoxin levels. J Clin Pharmacol 1981; 21:449-455. DOI
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Digoxin

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All Digoxin interactions (453) Digoxin drug information
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Kaolin

Keep reading about Kaolin

All Kaolin interactions (7)
Also serious with: Hydroxychloroquine
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

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.