Digoxin and Rifampin interaction

Digoxin and Rifampin: 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 Digoxin label · effective 2025-04-10

Moderate

Digoxin Concentrations Decreased Acarbose, Activated Charcoal, Albuterol, Antacids, certain cancer chemotherapy or radiation therapy, Cholestyramine, Colestipol, Exenatide, Kaolin-pectin, Meals High in Bran, Metoclopramide, Miglitol, Neomycin, Penicillamine, Phenytoin, Rifampin, St.

Drug interactionsnames RifampinView label on DailyMed
Minor

PGP Inducers/Inhibitors: Drugs that induce or inhibit PGP have the potential to alter digoxin pharmacokinetics.

Drug interactionsby drug classView label on DailyMed
Minor

P-Glycoprotein (PGP) Inducers/Inhibitors Digoxin is a substrate for P-glycoprotein, at the level of intestinal absorption, renal tubular section and biliary-intestinal secretion.

Drug interactionsby drug classView label on DailyMed

From the Rifampin (Rifadin IV) label · effective 2026-05-27

Moderate

Continue monitoring and increase digoxin dose by approximately 20%–40% as necessary.

Drug interactionsnames DigoxinView label on DailyMed
Moderate

…non-hormonal methods of birth control during rifampin therapy Estrogens Decrease exposure Progestins Anticonvulsants Phenytoin Administered with rifampin 450 mg daily Decrease exposure Antiarrhythmics Disopyramide Decrease exposure Mexiletine Decrease exposure Quinidine Decrease exposure Propafenone Decrease AUC by 50%–67% Tocainide Decrease exposure Antiestrogens…

Drug interactionsby drug classView label on DailyMed
Moderate

Prednisolone Decrease exposure Cardiac Glycosides Digoxin Prevention or Management: Measure serum digoxin concentrations before initiating rifampin.

Drug interactionsby drug classView label on DailyMed

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

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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.