Glecaprevir and Digoxin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Digoxin
Glecaprevir
No brand names on record
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
Concurrent use of digoxin and glecaprevir/pibrentasvir may result in increased digoxin plasma levels due to the inhibition of P-gp-mediated digoxin efflux transport. Measure serum digoxin concentration before initiating treatment. Decrease the digoxin dose by approximately 50% or modify the dosing frequency to reduce digoxin concentrations and continue monitoring. In a study (n=12), when a single dose of digoxin was coadministered with glecaprevir 400 mg/pibrentasvir 120 mg once daily, mean digoxin Cmax increased by 72% and mean AUC increased by 48%1.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport of digoxin
Literature reports
1 report — tap to read
a) In a pharmacokinetic study (n=12), when a single dose of digoxin 0.5 mg was coadministered with glecaprevir 400 mg/pibrentasvir 120 mg once daily, mean digoxin Cmax increased by 72% and mean AUC increased by 48% 1.
Common questions
Can I take Glecaprevir and Digoxin together?
Increased digoxin exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Glecaprevir and Digoxin interaction?
It is rated moderate. Can be significant — usually manageable with 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 Glecaprevir or Digoxin 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 anything you'd monitor while I'm on both?
References (1)
- Product Information: MAVYRET(R) oral tablets, oral pellets, glecaprevir pibrentasvir oral tablets, oral pellets. AbbVie Inc (per FDA), North Chicago, IL, 2023. DailyMed
Keep reading about Digoxin
Keep reading about Glecaprevir
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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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