Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
When these two medicines are taken together, the amount of digoxin absorbed by your body may decrease.
What might happen:
Your digoxin blood level may decrease and cause a decrease in the beneficial effects on your heart.
What you should do about this interaction:
If your doctor prescribes these medicines together, you may need to have your blood level of digoxin measured more regularly. Your doctor may need to adjust the dose.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Kuhlmann J, Zilly W, Wilke J. Effects of cytostatic drugs on plasma level and renal excretion of beta- acetyldigoxin. Clin Pharmacol Ther 1981 Oct; 30(4):518-27.
2.Kuhlmann J, Wilke J, Rietbrock N. Cytostatic drugs are without significant effect on digitoxin plasma level and renal excretion. Clin Pharmacol Ther 1982 Nov;32(5):646-51.
3.Bjornsson TD, Huang AT, Roth P, Jacob DS, Christenson R. Effects of high-dose cancer chemotherapy on the absorption of digoxin in two different formulations. Clin Pharmacol Ther 1986 Jan;39(1):25-8.