Digoxin/Propafenone;Flecainide Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

The cause of the interaction is not known. Propafenone or flecainide may increase the effects of your digoxin.

What might happen:

The blood levels of your digoxin may increase and cause nausea, vomiting, or a slow or irregular heartbeat.

What you should do about this interaction:

If you experience nausea, vomiting, or a slow or irregular heartbeat, contact your healthcare professional (e.g. doctor or pharmacist.) You may need to have your digoxin level checked and your doctor may want to adjust the dose of your medicine.Your healthcare professionals 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.Cardaioli P, Compostella L, De Domenico R, Papalia D, Zeppellini R, Libardoni M, Pulido E, Cucchini F. Effect of propafenone on the pharmacokinetics of digoxin administered orally: a study in healthy volunteers. G Ital Cardiol 1986 Mar;16(3):237-40.
  • 2.Belz GG, Doering W, Munkes R, Matthews J. Interaction between digoxin and calcium antagonists and antiarrhythmic drugs. Clin Pharmacol Ther 1983 Apr;33(4):410-7.
  • 3.Salerno DM, Granrud G, Sharkey P, Asinger R, Hodges M. A controlled trial of propafenone for treatment of frequent and repetitive ventricular premature complexes. Am J Cardiol 1984 Jan 1;53(1):77-83.
  • 4.Calvo MV, Martin Suarez A, Avila MC, Martin Luengo C. Digoxin-propafenone interaction. Med Clin (Barc) 1987 Jun 20;89(4):171-2.
  • 5.Nolan PE Jr, Marcus FI, Erstad BL, Hoyer GL, Furman C, Kirsten EB. Effects of coadministration of propafenone on the pharmacokinetics of digoxin in healthy volunteer subjects. J Clin Pharmacol 1989 Jan;29(1):46-52.
  • 6.Calvo MV, Martin-Suarez A, Martin Luengo C, Avila C, Cascon M, Dominguez-Gil Hurle A. Interaction between digoxin and propafenone. Ther Drug Monit 1989;11(1):10-5.
  • 7.Zalzstein E, Koren G, Bryson SM, Freedom RM. Interaction between digoxin and propafenone in children. J Pediatr 1990 Feb;116(2):310-2.
  • 8.Bigot MC, Debruyne D, Bonnefoy L, Grollier G, Moulin M, Potier JC. Serum digoxin levels related to plasma propafenone levels during concomitant treatment. J Clin Pharmacol 1991 Jun;31(6):521-6.
  • 9.Hii JT, Duff HJ, Burgess ED. Clinical pharmacokinetics of propafenone. Clin Pharmacokinet 1991 Jul;21(1):1-10.
  • 10.Lewis GP, Holtzman JL. Interaction of flecainide with digoxin and propranolol. Am J Cardiol 1984 Feb 27;53(5):52B-57B.
  • 11.Weeks CE, Conard GJ, Kvam DC, Fox JM, Chang SF, Paone RP, Lewis GP. The effect of flecainide acetate, a new antiarrhythmic, on plasma digoxin levels. J Clin Pharmacol 1986 Jan;26(1):27-31.
  • 12.Quart BD, Gallo DG, Sami MH, Wood AJ. Drug interaction studies and encainide use in renal and hepatic impairment. Am J Cardiol 1986 Aug 29; 58(5):104C-113C.
  • 13.Sami MH, Derbekyan VA, Lisbona R. Hemodynamic effects of encainide in patients with ventricular arrhythmia and poor ventricular function. Am J Cardiol 1983 Sep 1;52(5):507-11.
  • 14.Lanoxin (digoxin) Tablets US prescribing information. Covis Pharmaceuticals, Inc. August, 2018.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.