Pancuronium and Digoxin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Digoxin
Pancuronium
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
An increased risk of cardiac arrhythmias
Interaction Deep Dive
Concomitant digoxin and pancuronium therapy has been reported to result in cardiac arrhythmias. Possible mechanisms for this interaction include the vagolytic effect of pancuronium, the direct sympathomimetic and indirect sympathomimetic effects of pancuronium, and the prevention of norepinephrine reuptake by pancuronium1.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) The incidence of arrhythmias in digitalized patients who received either succinylcholine or pancuronium were compared. They divided 104 patients into four groups: Groups 1 and 2 were not receiving digitalis therapy, and Groups 3 and 4 were maintained on digoxin, diuretic therapy, and potassium supplementation. Patients in Groups 1 and 3 received succinylcholine 2 mg/kg while Groups 2 and 4 were administered pancuronium 0.12 mg/kg. Results showed that the incidence of dysrhythmias was significantly higher in the Group 4 patients who were receiving digoxin and pancuronium (6 out of 18 patients) than in Group 3, who received digoxin and succinylcholine (3 out of 46 patients). Types of arrhythmias seen in Group 4 included sinus tachycardia (n=4) and atrial flutter (n=2). Due to ethical reasons, the investigators terminated the administration of pancuronium to the digitalized patients 1.
Common questions
Can I take Pancuronium and Digoxin together?
An increased risk of cardiac arrhythmias Always confirm with your pharmacist or prescriber before making any change.
How serious is the Pancuronium and Digoxin interaction?
It is rated moderate. Can be significant — usually manageable with 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 Pancuronium 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)
- Bartolone RS & Rao TLK: Dysrhythmias following muscle relaxant administration in patients receiving digitalis. Anesthesiology 1983; 58:567-569. PubMed
Keep reading about Digoxin
Keep reading about Pancuronium
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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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