Major
Digoxin × Propafenone
Cardiac glycosides (digitalis)×Class Ic antiarrhythmic with beta-blocking activity
Mechanism
Propafenone inhibits renal P-glycoprotein. Digoxin rises 50-75%.
Symptoms
Nausea, yellow vision, bradycardia.
Management
Reduce digoxin by 50%, check level on day 5.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Sources
- FDA: Rythmol (propafenone) prescribing information (2013)– FDA Rythmol label