How the interaction occurs:
When these two medicines are taken together, your body may not process digoxin properly.
What might happen:
The blood levels of digoxin may increase and cause toxic effects.
What you should do about this interaction:
If you experience nausea, vomiting, diarrhea, loss of appetite, slow or irregular heartbeat, or vision changes (e.g. blurred vision or yellow/ green halos around objects), contact your doctor. You may need to have your blood level of digoxin checked, and your dose may need to be adjusted. This interaction may be worse in the elderly, or those with liver problems.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this drug 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.Wandell M, Powell JR, Hager WD, Fenster PE, Graves PE, Conrad KA, Goldman S. Effect of quinine on digoxin kinetics. Clin Pharmacol Ther 1980 Oct; 28(4):425-30.
2.Aronson JK, Carver JG. Interaction of digoxin with quinine. Lancet 1981 Jun 27;1(8235):1418.
3.Pedersen KE, Lysgaard Madsen J, Klitgaard NA, Kjaer K, Hvidt S. Effect of quinine on plasma digoxin concentration and renal digoxin clearance. Acta Med Scand 1985;218(2):229-32.
4.Hedman A, Angelin B, Arvidsson A, Dahlqvist R, Nilsson B. Interactions in the renal and biliary elimination of digoxin: stereoselective difference between quinine and quinidine. Clin Pharmacol Ther 1990 Jan;47(1):20-6.
5.Hedman A. Inhibition by basic drugs of digoxin secretion into human bile. Eur J Clin Pharmacol 1992;42(4):457-9.
6.Lanoxin (digoxin) Tablets US prescribing information. GlaxoSmithKline August, 2012.