Digoxin with Tetracycline Interaction Details
Brand Names Associated with Digoxin
- Cardoxin®
- Digitek®
- Digoxin
- Lanoxicaps®
- Lanoxin®
Brand Names Associated with Tetracycline
- Achromycin V®
- Sumycin®
- Tetracycline
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jan 08, 2024
Interaction Effect
Increased digoxin levels and digoxin toxicity (nausea, vomiting, cardiac arrhythmias)
Interaction Summary
Concomitant administration of tetracycline and digoxin increased digoxin serum concentrations 100%. In approximately 10% of patients, digoxin is converted to cardio-inactive metabolites by colonic bacteria within the gut. In these patients the coadministration of digoxin with tetracycline inhibits this metabolism and results in a significant increase in serum digoxin concentrations . Measure digoxin serum concentrations before initiating concomitant drugs. Decrease digoxin dose (by approximately 30% to 50% for oral) or modify frequency of dosing; continue monitoring .
Severity
Major
Onset
Delayed
Evidence
Probable
How To Manage Interaction
Concomitant administration of tetracycline and digoxin may increase digoxin serum concentrations. Measure digoxin serum concentrations before initiating concomitant drugs. Decrease digoxin dose (by approximately 30% to 50% for oral) or modify frequency of dosing; continue monitoring .
Mechanism Of Interaction
Unknown
Literature Reports
A) In pharmacokinetic studies, concomitant administration of tetracycline and digoxin increased digoxin serum concentrations 100% .
B) Approximately 10% of patients receiving digoxin convert the drug to cardio-inactive metabolites. This inactivation may be attributed to gastrointestinal bacteria. Antibiotic therapy introduced to patients on digoxin has caused a marked decrease in digoxin reduction products and a marked rise in digoxin absorption and serum levels. It is concluded that changes in the enteric flora via antibiotics may alter the state of digitalization. Elevated serum digoxin concentrations by as much as 43% to 116% were observed after a 5-day course of tetracycline in 3 volunteers who produced large amounts of digoxin reduction products .
Digoxin Overview
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Digoxin is used to treat heart failure and abnormal heart rhythms (arrhythmias). It helps the heart work better and it helps control your heart rate.
Tetracycline Overview
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Tetracycline is used to treat infections caused by bacteria including pneumonia and other respiratory tract infections; ; certain infections of skin, eye, lymphatic, intestinal, genital and urinary systems; and certain other infections that are spread by ticks, lice, mites, and infected animals. It is also used along with other medications to treat acne. Tetracycline is also used to treat plague and tuleramia (serious infections that may be spread on purpose as part of a bioterror attack). It can also be used in patients who cannot be treated with penicillin to treat certain types of food poisoning, and anthrax (a serious infection that may be spread on purpose as part of a bioterror attack). Tetracycline is in a class of medications called tetracycline antibiotics. It works by preventing the growth and spread of bacteria.
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Antibiotics such as tetracycline will not work for colds, flu, or other viral infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.