Digoxin and Telaprevir: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Telaprevir
No brand names on recordDigoxin
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 exposure
Interaction Deep Dive
Concomitant use of digoxin and telaprevir may lead to increased digoxin exposure. When coadministered with telaprevir, initiate digoxin treatment at the lowest dose. Monitor serum digoxin exposure and titrate the digoxin dose accordingly4. Reduce digoxin concentrations by decreasing dose by approximately 30-50% or by modifying the dosing frequency and continue monitoring 12. Also, monitor potential signs and symptoms of clinical toxicity is necessary when initiating, adjusting, or discontinuing telaprevir 3.
Why it happens (mechanism)
Inhibition of P-gp mediated efflux transport of digoxin
Literature reports
2 reports — tap to read
a) In drug interaction studies, the concomitant administration of digoxin and telaprevir resulted in an increase in digoxin AUC and Cmax. Patients (n=20) received telaprevir 750 mg every 8 hours for 11 days and a single dose of digoxin 2 mg. Comparing digoxin plus telaprevir versus digoxin administration alone, the ratio estimate for digoxin Cmax was 1.5 (90% confidence interval (CI), 1.36 to 1.65), and for AUC was 1.85 (90% CI, 1.7 to 2) 4.
b) During pharmacokinetic studies, coadministration of amiodarone and oral telaprevir resulted in a 50% increase in digoxin serum concentrations and a 85% increase in digoxin AUC 12.
Common questions
Can I take Digoxin and Telaprevir together?
Increased digoxin exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Digoxin and Telaprevir 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 "established". Well documented — supported by controlled studies or strong clinical data.
Questions for your pharmacist
- Does my dose of Digoxin or Telaprevir 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)
- 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
- Product Information: DIGOXIN intravenous injection, digoxin intravenous injection. Hikma Pharmaceuticals USA Inc. (per Dailymed), Berkeley Heights, NJ, 2023. DailyMed
- Product Information: INCIVEK(TM) film coated oral tablets, telaprevir film coated oral tablets. Vertex Pharmaceuticals Incorporated, Cambridge, MA, 2011.
Keep reading about Telaprevir
Keep reading about Digoxin
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
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