Digoxin and Propafenone interaction

Digoxin and Propafenone: the Propafenone prescribing label flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Propafenone (propafenone hydrochloride) label · effective 2026-01-29

Major

• The applicability of the CAST results to other populations (e.g., those without recent myocardial infarction) or other antiarrhythmic drugs is uncertain, but at present, it is prudent to consider any IC antiarrhythmic to have a significant proarrhythmic risk in patients with structural heart disease.

Boxed warningby drug classView label on DailyMed
Major

• Avoid use with other antiarrhythmic agents or drugs that prolong the QT interval.

Warnings and precautionsby drug classView label on DailyMed
Moderate

• Propafenone may increase digoxin or warfarin levels.

Drug interactionsnames DigoxinView label on DailyMed
Moderate

Digoxin Concomitant use of propafenone and digoxin increased steady-state serum digoxin exposure (AUC) in patients by 60% to 270% and decreased the clearance of digoxin by 31% to 67%.

Drug interactionsnames DigoxinView label on DailyMed
Moderate

Monitor plasma digoxin levels of patients receiving propafenone and adjust digoxin dosage as needed.

Drug interactionsnames DigoxinView label on DailyMed

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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.