Alprazolam and Digoxin interaction

Alprazolam and Digoxin: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Alprazolam (Alprazolam XR) label · effective 2025-02-11

Moderate

• Use with Digoxin: Increase the risk of digoxin toxicity.

Drug interactionsnames DigoxinView label on DailyMed
Moderate

Digoxin Clinical implication Increased digoxin concentrations have been reported when alprazolam was given, especially in geriatric patients (>65 years of age).

Drug interactionsnames DigoxinView label on DailyMed
Moderate

Continue monitoring digoxin serum concentration and toxicity frequently.

Drug interactionsnames DigoxinView label on DailyMed
Moderate

Reduce the digoxin dose if necessary.

Drug interactionsnames DigoxinView label on DailyMed
Minor

Prevention or management In patients on digoxin therapy, measure serum digoxin concentrations before initiating alprazolam XR.

Drug interactionsnames DigoxinView label on DailyMed

From the Digoxin label · effective 2025-04-10

Moderate

…Saquinavir 27% 49% Spironolactone 25% NA Telmisartan 20 to 49% NA Ticagrelor 31% 28% Tolvaptan 30% 20% Trimethoprim 22 to 28% NA Digoxin Concentrations Increased, but Magnitude is Unclear Alprazolam, Azithromycin, Cyclosporine, Diclofenac, Diphenoxylate, Epoprostenol, Esomeprazole, Ibuprofen, Ketoconazole, Lansoprazole, Metformin, Omeprazole Measure serum digoxin concentrations…

Drug interactionsnames AlprazolamView label on DailyMed

Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.

Open in the checker

Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.