Hawthorn and Digoxin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Digoxin
Hawthorn
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
Potentiation of digoxin effects
Interaction Deep Dive
Coadministration of hawthorn and digoxin should be avoided. Hawthorn treatment (administered in the form of leaves, flowers, or berries) causes a concentration-dependent increase in myocardial contractility, prolongation of action potentials and refractory periods, and vasorelaxation by an endothelium-dependent and nitric oxide-mediated mechanism; therefore, coadministration with digoxin may result in a pharmacodynamic drug interaction1.
Why it happens (mechanism)
Increased myocardial contractility, prolongation of action potential and refractory period, and vasodilation
Common questions
Can I take Hawthorn and Digoxin together?
Potentiation of digoxin effects Always confirm with your pharmacist or prescriber before making any change.
How serious is the Hawthorn and Digoxin 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 "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Hawthorn 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 a safer alternative to one of these medications for me?
References (1)
- Chow SL, Bozkurt B, Baker WL, et al: Complementary and alternative medicines in the management of heart failure: a scientific statement from the American Heart Association. Circulation 2023; 147(2):e4-e30. PubMed
Keep reading about Digoxin
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:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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