Chemical: Drug
digoxin

PharmGKB contains no dosing guidelines for this . To report known genotype-based dosing guidelines, or if you are interested in developing guidelines, click here.


1. FDA Label for digoxin

Full label available at DailyMed

Genes and/or phenotypes found in this label

  • Arrhythmias, Cardiac
    • Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Atrial Fibrillation
    • Indications & usage section, Warnings section, Precautions section
    • source: PHONT
  • Heart Failure
    • Indications & usage section, Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Hyperthyroidism
    • Precautions section
    • source: PHONT
  • Hypothyroidism
    • Precautions section
    • source: PHONT

PharmGKB contains no Clinical Variants that meet the highest level of criteria.

To see more Clinical Variants with lower levels of criteria, click the button at the bottom of the page.

Disclaimer: The PharmGKB's clinical annotations reflect expert consensus based on clinical evidence and peer-reviewed literature available at the time they are written and are intended only to assist clinicians in decision-making and to identify questions for further research. New evidence may have emerged since the time an annotation was submitted to the PharmGKB. The annotations are limited in scope and are not applicable to interventions or diseases that are not specifically identified.

The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

? = Mouse-over for quick help

The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

List of all variant annotations for digoxin

Gene ? Variant?
(147)
Alternate Names ? Chemicals ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
Translation
VIP No VIP available No VIP available ABCB1 *13 (PMID: 12893986) N/A N/A N/A
VIP No VIP available No VIP available ABCB1 *2 (PMID: 11503014) N/A N/A N/A
No VIP available CA VA
rs1042713 NC_000005.10:g.148826877G=, NC_000005.10:g.148826877G>A, NC_000005.9:g.148206440G=, NC_000005.9:g.148206440G>A, NG_016421.1:g.5285A=, NG_016421.1:g.5285A>G, NM_000024.5:c.46A=, NM_000024.5:c.46A>G, NP_000015.1:p.Arg16=, NP_000015.1:p.Arg16Gly, XM_005268382.1:c.46G=, XM_005268382.1:c.46G>A, XM_005268383.1:c.46G=, XM_005268383.1:c.46G>A, XP_005268439.1:p.Gly16=, XP_005268439.1:p.Gly16Arg, XP_005268440.1:p.Gly16=, XP_005268440.1:p.Gly16Arg, rs17287432, rs17334179, rs17334242, rs17721693, rs17839749, rs17846639, rs17859732, rs3182174, rs3729940, rs52812686, rs56964295
G > A
SNP
R16G
No VIP available No Clinical Annotations available VA
rs1042714 NC_000005.10:g.148826910G=, NC_000005.10:g.148826910G>C, NC_000005.9:g.148206473G=, NC_000005.9:g.148206473G>C, NG_016421.1:g.5318C=, NG_016421.1:g.5318C>G, NM_000024.5:c.79C=, NM_000024.5:c.79C>G, NP_000015.1:p.Gln27=, NP_000015.1:p.Gln27Glu, XM_005268382.1:c.79G=, XM_005268382.1:c.79G>C, XM_005268383.1:c.79G=, XM_005268383.1:c.79G>C, XP_005268439.1:p.Glu27=, XP_005268439.1:p.Glu27Gln, XP_005268440.1:p.Glu27=, XP_005268440.1:p.Glu27Gln, rs17287411, rs17287474, rs17334200, rs17640526, rs17845338, rs17858183, rs17859733, rs3182175, rs3729941, rs52793394, rs60374884
G > C
G > T
SNP
Q27E
rs1045642 NC_000007.13:g.87138645A>G, NC_000007.14:g.87509329A>G, NG_011513.1:g.208920T>C, NM_000927.4:c.3435T>C, NP_000918.2:p.Ile1145=, rs10239679, rs11568726, rs117328163, rs17210003, rs2229108, rs386513066, rs60023214, rs9690664
A > G
SNP
I1145I
No VIP available No Clinical Annotations available VA
rs1126742 NC_000001.10:g.47398496A>G, NC_000001.11:g.46932824A>G, NG_007932.1:g.13661T>C, NM_000778.3:c.1301T>C, NM_001319155.1:c.1205T>C, NP_000769.2:p.Phe434Ser, NP_001306084.1:p.Phe402Ser, NR_134988.1:n.1006T>C, NR_134989.1:n.1197T>C, NR_134990.1:n.1191T>C, NR_134991.1:n.1178T>C, NR_134992.1:n.807T>C, NR_134993.1:n.941T>C, NR_134994.1:n.1213T>C, XM_005270537.1:c.989T>C, XM_005270538.1:c.911T>C, XM_005270539.1:c.1007T>C, XM_011540826.1:c.1319T>C, XM_011540827.1:c.1025T>C, XM_011540828.1:c.1007T>C, XP_005270594.1:p.Phe330Ser, XP_005270595.1:p.Phe304Ser, XP_005270596.1:p.Phe336Ser, XP_011539128.1:p.Phe440Ser, XP_011539129.1:p.Phe342Ser, XP_011539130.1:p.Phe336Ser, XR_246241.1:n.1205T>C, XR_246242.1:n.1189T>C, rs17411649, rs3181965, rs4233507, rs56782585
A > -
A > G
SNP
F434S
No VIP available CA VA
rs1128503 NC_000007.13:g.87179601A>G, NC_000007.14:g.87550285A>G, NG_011513.1:g.167964T>C, NM_000927.4:c.1236T>C, NP_000918.2:p.Gly412=, rs116989428, rs17276907, rs2032587, rs2229105, rs28365046, rs386518005, rs58257317
A > G
SNP
G412G
No VIP available No Clinical Annotations available VA
rs1799752 NC_000017.10:g.61565890_61565891insATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC, NC_000017.10:g.61565890_61565891insG, NC_000017.11:g.63488529_63488530insATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC, NC_000017.11:g.63488529_63488530insG, NG_011648.1:g.16457_16458insATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC, NG_011648.1:g.16457_16458insG, NM_000789.3:c.2306-119_2306-118insATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC, NM_000789.3:c.2306-119_2306-118insG, NM_001178057.1:c.584-119_584-118insATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC, NM_001178057.1:c.584-119_584-118insG, NM_152830.2:c.584-119_584-118insATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC, NM_152830.2:c.584-119_584-118insG, XM_005257110.1:c.1757-119_1757-118insATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC, XM_005257110.1:c.1757-119_1757-118insG, XM_006721737.2:c.644-119_644-118insATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC, XM_006721737.2:c.644-119_644-118insG
- > ATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC
- > G
indel
No VIP available CA VA
rs1799983 NC_000007.13:g.150696111T>G, NC_000007.14:g.150999023T>G, NG_011992.1:g.12965T>G, NM_000603.4:c.894T>G, NM_001160109.1:c.894T>G, NM_001160110.1:c.894T>G, NM_001160111.1:c.894T>G, NP_000594.2:p.Asp298Glu, NP_001153581.1:p.Asp298Glu, NP_001153582.1:p.Asp298Glu, NP_001153583.1:p.Asp298Glu, XM_006716002.2:c.894T>G, XP_006716065.1:p.Asp298Glu, rs11266811, rs13238975, rs13305983, rs13308813, rs17173672, rs3730304, rs57135373
T > G
SNP
D298E
No VIP available No Clinical Annotations available VA
rs1801252 NC_000010.10:g.115804036A>G, NC_000010.11:g.114044277A>G, NG_012187.1:g.5231A>G, NM_000684.2:c.145A>G, NP_000675.1:p.Ser49Gly, rs12720482, rs3740152
A > G
SNP
S49G
No VIP available CA VA
rs1801253 NC_000010.10:g.115805056G>C, NC_000010.11:g.114045297G>C, NG_012187.1:g.6251G>C, NM_000684.2:c.1165G>C, NP_000675.1:p.Gly389Arg, rs12718339, rs17091259, rs28365052, rs59130083
G > C
SNP
G389R
rs2032582 NC_000007.13:g.87160618A>C, NC_000007.13:g.87160618A>T, NC_000007.14:g.87531302A>C, NC_000007.14:g.87531302A>T, NG_011513.1:g.186947T>A, NG_011513.1:g.186947T>G, NM_000927.4:c.2677T>A, NM_000927.4:c.2677T>G, NP_000918.2:p.Ser893Ala, NP_000918.2:p.Ser893Thr, rs10228331, rs2229106, rs386553610, rs57135550, rs9641018
A > C
SNP
S893A
No VIP available No Clinical Annotations available VA
rs61767072 NC_000004.11:g.3769297_3769308delGGGGCGGGGCCG, NC_000004.12:g.3767570_3767581delGGGGCGGGGCCG, NG_012640.1:g.6002_6013delGGGGCGGGGCCG, NM_000683.3:c.964_975delGGGGCGGGGCCG, NP_000674.2:p.Gly324_Ala327del
GGGGCGGGGCCG > -
indel
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 147

Overview

Generic Names
  • Digitalis Glycoside
Trade Names
  • Cardoxin
  • Cogoxin
  • Cordioxil
  • Davoxin
  • Digacin
  • Digitekt
  • Digoxin Pediatric
  • Dilanacin
  • Dixina
  • Dokim
  • Dynamos
  • Eudigox
  • Homolle's Digitalin
  • Lanacordin
  • Lanacrist
  • Lanicor
  • Lanoxicaps
  • Lanoxin
  • Lenoxicaps
  • Lenoxin
  • Longdigox
  • Neo-Lanicor
  • Neodioxanin
  • Rougoxin
  • SK-Digoxin
  • Stillacor
  • Vanoxin
Brand Mixture Names

PharmGKB Accession Id

PA449319

Type(s):

Drug

Description

A cardiotonic glycoside obtained mainly from Digitalis lanata; it consists of three sugars and the aglycone digoxigenin. Digoxin has positive inotropic and negative chronotropic activity. It is used to control ventricular rate in atrial fibrillation and in the management of congestive heart failure with atrial fibrillation. Its use in congestive heart failure and sinus rhythm is less certain. The margin between toxic and therapeutic doses is small. (From Martindale, The Extra Pharmacopoeia, 30th ed, p666)

Source: Drug Bank

Indication

For the treatment and management of congestive cardiac insufficiency, arrhythmias and heart failure.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

Digoxin inhibits the Na-K-ATPase membrane pump, resulting in an increase in intracellular sodium. The sodium calcium exchanger (NCX)in turn tries to extrude the sodium and in so doing, pumps in more calcium. Increased intracellular concentrations of calcium may promote activation of contractile proteins (e.g., actin, myosin). Digoxin also acts on the electrical activity of the heart, increasing the slope of phase 4 depolarization, shortening the action potential duration, and decreasing the maximal diastolic potential.

Source: Drug Bank

Pharmacology

Digoxin, a cardiac glycoside similar to digitoxin, is used to treat congestive heart failure and supraventricular arrhythmias due to reentry mechanisms, and to control ventricular rate in the treatment of chronic atrial fibrillation.

Source: Drug Bank

Food Interaction

Avoid avocado.|Limit garlic, ginger, gingko, and horse chestnut.|Avoid milk, calcium containing dairy products, iron, antacids, or aluminum salts 2 hours before or 6 hours after using antacids while on this medication.|Avoid bran and high fiber foods within 2 hours of taking this medication.|Avoid salt substitutes containing potassium.|Avoid excess salt/sodium unless otherwise instructed by your physician.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic (but not dependent upon the cytochrome P-450 system). The end metabolites, which include 3 b-digoxigenin, 3-keto-digoxigenin, and their glucuronide and sulfate conjugates, are polar in nature and are postulated to be formed via hydrolysis, oxidation, and conjugation.

Source: Drug Bank

Protein Binding

25%

Source: Drug Bank

Absorption

Absorption of digoxin from the elixir pediatric formulation has been demonstrated to be 70% to 85% complete (90% to 100% from the capsules, and 60% to 80% for tablets).

Source: Drug Bank

Half-Life

3.5 to 5 days

Source: Drug Bank

Toxicity

Toxicity includes ventricular tachycardia or ventricular fibrillation, or progressive bradyarrhythmias, or heart block. LD 50 = 7.8 mg/kg (orally in mice).

Source: Drug Bank

Route of Elimination

Following intravenous administration to healthy volunteers, 50% to 70% of a digoxin dose is excreted unchanged in the urine.

Source: Drug Bank

Chemical Properties

Chemical Formula

C41H64O14

Source: Drug Bank

Isomeric SMILES

C[C@@H]1[C@H]([C@H](C[C@@H](O1)O[C@@H]2[C@H](O[C@H](C[C@@H]2O)O[C@@H]3[C@H](O[C@H](C[C@@H]3O)O[C@H]4CC[C@]5([C@@H](C4)CC[C@@H]6[C@@H]5C[C@H]([C@]7([C@@]6(CC[C@@H]7C8=CC(=O)OC8)O)C)O)C)C)C)O)O

Source: Drug Bank

[H][C@]12CC[C@]3([H])[C@]([H])(C[C@@H](O)[C@]4(C)C(CC[C@]34O)C3=CC(=O)OC3)[C@@]1(C)CC[C@@H](C2)O[C@H]1C[C@H](O)[C@H](O[C@H]2C[C@H](O)[C@H](O[C@H]3C[C@H](O)[C@H](O)[C@@H](C)O3)[C@@H](C)O2)[C@@H](C)O1

Source: Drug Bank

Canonical SMILES

[H][C@]

Source: Drug Bank

Average Molecular Weight

780.9385

Source: Drug Bank

Monoisotopic Molecular Weight

780.429606756

Source: Drug Bank

SMILES

[H][C@]12CC[C@]3([H])[C@]([H])(C[C@@H](O)[C@]4(C)[C@H](CC[C@]34O)C3=CC(=O)OC3)[C@@]1(C)CC[C@@H](C2)O[C@H]1C[C@H](O)[C@H](O[C@H]2C[C@H](O)[C@H](O[C@H]3C[C@H](O)[C@H](O)[C@@H](C)O3)[C@@H](C)O2)[C@@H](C)O1

Source: Drug Bank

InChI String

InChI=1S/C41H64O14/c1-19-36(47)28(42)15-34(50-19)54-38-21(3)52-35(17-30(38)44)55-37-20(2)51-33(16-29(37)43)53-24-8-10-39(4)23(13-24)6-7-26-27(39)14-31(45)40(5)25(9-11-41(26,40)48)22-12-32(46)49-18-22/h12,19-21,23-31,33-38,42-45,47-48H,6-11,13-18H2,1-5H3/t19-,20-,21-,23-,24+,25-,26-,27+,28+,29+,30+,31-,33+,34+,35+,36-,37-,38-,39+,40+,41+/m1/s1

Source: Drug Bank

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

Drug Targets

Gene Description
ATP1A1 (source: Drug Bank)
SLCO1B1 (source: Drug Bank)

Drug Interactions

Interaction Description
acarbose - digoxin Decreased serum levels of digoxin, it is thought that acarbose reduces digoxin absorption. (source: Drug Bank)
acarbose - digoxin Decreased serum levels of digoxin, it is thought that acarbose reduces digoxin absorption. (source: Drug Bank)
alprazolam - digoxin The benzodiazepine increases the effect (source: Drug Bank)
alprazolam - digoxin The benzodiazepine increases the effect (source: Drug Bank)
amiodarone - digoxin Increases the effect of digoxin (source: Drug Bank)
amiodarone - digoxin Increases the effect of digoxin (source: Drug Bank)
bendroflumethiazide - digoxin Possible electrolyte variations and arrhythmias (source: Drug Bank)
bendroflumethiazide - digoxin Possible electrolyte variations and arrhythmias (source: Drug Bank)
bumetanide - digoxin Possible electrolyte variations and arrhythmias (source: Drug Bank)
bumetanide - digoxin Possible electrolyte variations and arrhythmias (source: Drug Bank)
carvedilol - digoxin Increases levels/effect of digoxin (source: Drug Bank)
carvedilol - digoxin Increases levels/effect of digoxin (source: Drug Bank)
chlorthalidone - digoxin Possible electrolyte variations and arrhythmias (source: Drug Bank)
chlorthalidone - digoxin Possible electrolyte variations and arrhythmias (source: Drug Bank)
cholestyramine - digoxin The resin decreases the effect of digoxin (source: Drug Bank)
cholestyramine - digoxin The resin decreases the effect of digoxin (source: Drug Bank)
clarithromycin - digoxin The macrolide increases the effect of digoxin in 10% of patients (source: Drug Bank)
clarithromycin - digoxin The macrolide, clarithromycin, may increase the effect of digoxin in 10% of patients. (source: Drug Bank)
colestipol - digoxin The resin decreases the effect of digoxin (source: Drug Bank)
colestipol - digoxin The resin decreases the effect of digoxin (source: Drug Bank)
cyclosporine - digoxin Increases the effect of digoxin (source: Drug Bank)
cyclosporine - digoxin Increases the effect of digoxin (source: Drug Bank)
dextrothyroxine - digoxin The thyroid hormone, dextrothyroxine, decreases the effect of digoxin. (source: Drug Bank)
diazepam - digoxin The benzodiazepine increases the effect of digoxin (source: Drug Bank)
diazepam - digoxin The benzodiazepine increases the effect of digoxin (source: Drug Bank)
digoxin - acarbose Acarbose decreases the effect of digoxin (source: Drug Bank)
digoxin - acarbose Acarbose decreases the effect of digoxin (source: Drug Bank)
digoxin - alprazolam The benzodiazepine increases the effect of digoxin (source: Drug Bank)
digoxin - alprazolam The benzodiazepine increases the effect of digoxin (source: Drug Bank)
digoxin - amiodarone Amiodarone increases the effect of digoxin (source: Drug Bank)
digoxin - amiodarone Amiodarone increases the effect of digoxin (source: Drug Bank)
digoxin - bendroflumethiazide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - bendroflumethiazide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - benzthiazide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - bleomycin The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
digoxin - bleomycin The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
digoxin - bumetanide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - bumetanide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - carmustine The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
digoxin - carmustine The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
digoxin - carvedilol Carvedilol increases levels/effect of digoxin (source: Drug Bank)
digoxin - carvedilol Carvedilol increases levels/effect of digoxin (source: Drug Bank)
digoxin - chlorothiazide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - chlorothiazide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - chlorthalidone Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - chlorthalidone Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - cholestyramine The resin decreases the effect of digoxin (source: Drug Bank)
digoxin - cholestyramine The resin decreases the effect of digoxin (source: Drug Bank)
digoxin - clarithromycin The macrolide increases the effect of digoxin in 10% of patients (source: Drug Bank)
digoxin - clarithromycin The macrolide, clarithromycin, may increase the effect of digoxin in 10% of patients. (source: Drug Bank)
digoxin - colestipol The resin decreases the effect of digoxin (source: Drug Bank)
digoxin - colestipol The resin decreases the effect of digoxin (source: Drug Bank)
digoxin - cyclophosphamide The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
digoxin - cyclophosphamide The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
digoxin - cyclosporine Cyclosporine increases the effect of digoxin (source: Drug Bank)
digoxin - cyclosporine Cyclosporine increases the effect of digoxin (source: Drug Bank)
digoxin - cyclothiazide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - cyclothiazide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - cytarabine The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
digoxin - cytarabine The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
digoxin - dextrothyroxine The thyroid hormone, dextrothyroxine, decreases the effect of digoxin. (source: Drug Bank)
digoxin - diazepam The benzodiazepine increases the effect of digoxin (source: Drug Bank)
digoxin - diazepam The benzodiazepine increases the effect of digoxin (source: Drug Bank)
digoxin - doxorubicin The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
digoxin - doxorubicin The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
digoxin - doxycycline The tetracycline increases the effect of digoxin in 10% of patients (source: Drug Bank)
digoxin - erythromycin The macrolide increases the effect of digoxin in 10% of patients (source: Drug Bank)
digoxin - erythromycin The macrolide, erythromycin, may increase the effect of digoxin in 10% of patients. (source: Drug Bank)
digoxin - ethacrynic acid Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - furosemide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - furosemide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - gatifloxacin Gatifloxacin increases the effect of digoxin (source: Drug Bank)
digoxin - gatifloxacin Gatifloxacin increases the effect of digoxin (source: Drug Bank)
digoxin - ginseng Changes in digoxin serum levels (source: Drug Bank)
digoxin - hydrochlorothiazide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - hydrochlorothiazide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - hydroflumethiazide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - hydroxychloroquine Hydroxychloroquine increases the effect of digoxin (source: Drug Bank)
digoxin - indapamide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - indapamide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - itraconazole Itraconazole increases the effect of digoxin (source: Drug Bank)
digoxin - itraconazole Itraconazole increases the effect of digoxin (source: Drug Bank)
digoxin - josamycin The macrolide, josamycin, may increase the effect of digoxin in 10% of patients. (source: Drug Bank)
digoxin - levothyroxine The thyroid hormones decreases the effect of digoxin (source: Drug Bank)
digoxin - levothyroxine The thyroid hormone, levothyroxine, decreases the effect of digoxin. (source: Drug Bank)
digoxin - liothyronine The thyroid hormone, liothyronine, decreases the effect of digoxin. (source: Drug Bank)
digoxin - liotrix The thyroid hormone, liotrix, decreases the effect of digoxin. (source: Drug Bank)
digoxin - methimazole The antithyroid agent increases the effect of digoxin (source: Drug Bank)
digoxin - methimazole The antithyroid agent increases the effect of digoxin (source: Drug Bank)
digoxin - methotrexate The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
digoxin - methotrexate The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
digoxin - methyclothiazide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - metolazone Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - minocycline The tetracycline increases the effect of digoxin in 10% of patients (source: Drug Bank)
digoxin - oxytetracycline The tetracycline increases the effect of digoxin in 10% of patients (source: Drug Bank)
digoxin - penicillamine Penicillamine decreases the effect of digoxin (source: Drug Bank)
digoxin - penicillamine Penicillamine decreases the effect of digoxin (source: Drug Bank)
digoxin - polythiazide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - prazosin Prazosin increases the effect of digoxin (source: Drug Bank)
digoxin - prazosin Prazosin increases the effect of digoxin (source: Drug Bank)
digoxin - procarbazine The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
digoxin - procarbazine The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
digoxin - propafenone Propafenone increases the effect of digoxin (source: Drug Bank)
digoxin - propafenone Propafenone increases the effect of digoxin (source: Drug Bank)
digoxin - propylthiouracil The antithyroid agent increases the effect of digoxin (source: Drug Bank)
digoxin - propylthiouracil The antithyroid agent increases the effect of digoxin (source: Drug Bank)
digoxin - quinethazone Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - quinidine Quinine/quinidine increases the effect of digoxin (source: Drug Bank)
digoxin - quinidine Quinine/quinidine increases the effect of digoxin (source: Drug Bank)
digoxin - quinine Quinine/quinidine increases the effect of digoxin (source: Drug Bank)
digoxin - quinine Quinine/quinidine increases the effect of digoxin (source: Drug Bank)
digoxin - rabeprazole Rabeprazole increases the effect of digoxin (source: Drug Bank)
digoxin - rabeprazole Rabeprazole increases the effect of digoxin (source: Drug Bank)
digoxin - ranolazine Ranolazine increases digoxin's levels (source: Drug Bank)
digoxin - ritonavir Ritonavir increases levels/effect of digoxin (source: Drug Bank)
digoxin - ritonavir Ritonavir increases levels/effect of digoxin (source: Drug Bank)
digoxin - spironolactone Increased digoxin levels and decreased effect in presence of spironolactone (source: Drug Bank)
digoxin - spironolactone Increased digoxin levels and decreased effect in presence of spironolactone (source: Drug Bank)
digoxin - sulfasalazine Sulfasalazine decreases the effect of digoxin (source: Drug Bank)
digoxin - sulfasalazine Sulfasalazine may decrease the effect of digoxin. (source: Drug Bank)
digoxin - telithromycin Telithromycin may increase levels of digoxin (source: Drug Bank)
digoxin - telithromycin Telithromycin may increase levels of digoxin (source: Drug Bank)
digoxin - telmisartan Telmisartan increases the effect of digoxin (source: Drug Bank)
digoxin - telmisartan Telmisartan increases the effect of digoxin (source: Drug Bank)
digoxin - tetracycline The tetracycline increases the effect of digoxin in 10% of patients (source: Drug Bank)
digoxin - thyroglobulin The thyroid hormone, thyroglobulin, decreases the effect of digoxin. (source: Drug Bank)
digoxin - tolbutamide Tolbutamide increases the effect of digoxin (source: Drug Bank)
digoxin - tolbutamide Tolbutamide increases the effect of digoxin (source: Drug Bank)
digoxin - trichlormethiazide Possible electrolyte variations and arrhythmias (source: Drug Bank)
digoxin - verapamil Verapamil increases the effect of digoxin (source: Drug Bank)
digoxin - verapamil Verapamil increases the effect of digoxin (source: Drug Bank)
digoxin - vincristine The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
digoxin - vincristine The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
doxorubicin - digoxin The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
doxorubicin - digoxin The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
doxycycline - digoxin The tetracycline increases the effect of digoxin in 10% of patients (source: Drug Bank)
erythromycin - digoxin The macrolide increases the effect of digoxin in 10% of patients (source: Drug Bank)
erythromycin - digoxin The macrolide, erythromycin, may increase the effect of digoxin in 10% of patients. (source: Drug Bank)
ethacrynic acid - digoxin Possible electrolyte variations and arrhythmias (source: Drug Bank)
ethacrynic acid - digoxin Possible electrolyte variations and arrhythmias (source: Drug Bank)
furosemide - digoxin Possible electrolyte variations and arrhythmias (source: Drug Bank)
furosemide - digoxin Possible electrolyte variations and arrhythmias (source: Drug Bank)
gatifloxacin - digoxin Gatifloxacin increases the effect of digoxin (source: Drug Bank)
gatifloxacin - digoxin Gatifloxacin increases the effect of digoxin (source: Drug Bank)
hydrochlorothiazide - digoxin Possible electrolyte variations and arrhythmias (source: Drug Bank)
hydrochlorothiazide - digoxin Possible electrolyte variations and arrhythmias (source: Drug Bank)
indapamide - digoxin Possible electrolyte variations and arrhythmias (source: Drug Bank)
indapamide - digoxin Possible electrolyte variations and arrhythmias (source: Drug Bank)
itraconazole - digoxin Itraconazole increases the effect of digoxin (source: Drug Bank)
itraconazole - digoxin Itraconazole increases the effect of digoxin (source: Drug Bank)
levothyroxine - digoxin The thyroid hormone decreases the effect of digoxin (source: Drug Bank)
levothyroxine - digoxin The thyroid hormone, levothyroxine, decreases the effect of digoxin. (source: Drug Bank)
methimazole - digoxin The antithyroid agent increases the effect of digoxin (source: Drug Bank)
methimazole - digoxin The antithyroid agent increases the effect of digoxin (source: Drug Bank)
methotrexate - digoxin The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
methotrexate - digoxin The antineoplasic agent decreases the effect of digoxin (source: Drug Bank)
metolazone - digoxin Possible electrolyte variations and arrhythmias (source: Drug Bank)
minocycline - digoxin The tetracycline increases the effect of digoxin in 10% of patients (source: Drug Bank)
penciclovir - digoxin The multivalent agent decreases the effect of penicillamine (source: Drug Bank)
penciclovir - digoxin The multivalent agent decreases the effect of penicillamine (source: Drug Bank)
prazosin - digoxin Prazosin increases the effect of digoxin (source: Drug Bank)
prazosin - digoxin Prazosin increases the effect of digoxin (source: Drug Bank)
propafenone - digoxin Propafenone increases the effect of digoxin (source: Drug Bank)
propafenone - digoxin Propafenone increases the effect of digoxin (source: Drug Bank)
propylthiouracil - digoxin The anti-thyroid agent increases the effect of digoxin (source: Drug Bank)
propylthiouracil - digoxin The anti-thyroid agent increases the effect of digoxin (source: Drug Bank)
quinidine - digoxin Quinine/quinidine increases the effect of digoxin (source: Drug Bank)
quinidine - digoxin Quinine/quinidine increases the effect of digoxin (source: Drug Bank)
quinine - digoxin Quinine/quinidine increases the effect of digoxin (source: Drug Bank)
quinine - digoxin Quinine/quinidine increases the effect of digoxin (source: Drug Bank)
rabeprazole - digoxin Rabeprazole increases the effect of digoxin (source: Drug Bank)
rabeprazole - digoxin Rabeprazole increases the effect of digoxin (source: Drug Bank)
ranolazine - digoxin Ranolazine increases digoxin levels (source: Drug Bank)
telithromycin - digoxin Telithromycin may increase levels of digoxin (source: Drug Bank)
telithromycin - digoxin Telithromycin may increase the plasma concentration of Digoxin. Monitor for changes in Digoxin efficacy/toxicity if Telithromycin is initiated, discontinued or dose changed. (source: Drug Bank)
telmisartan - digoxin Telmisartan may increase plasma Digoxin concentrations. Monitor Digoxin levels and adjust dose as required if Telmisartan is initiated, discontinued or dose changed. (source: Drug Bank)
telmisartan - digoxin Telmisartan may increase plasma Digoxin concentrations. Monitor Digoxin levels and adjust dose as required if Telmisartan is initiated, discontinued or dose changed. (source: Drug Bank)
tetracycline - digoxin The tetracycline increases the effect of digoxin in 10% of patients (source: Drug Bank)
ticlopidine - digoxin Ticlopidine may decrease Digoxin levels. Monitor for Digoxin levels with Ticlopidine is initiated, discontinued or dose changed. (source: Drug Bank)
trimetrexate - digoxin The absorption of Digoxin, a cardiac glycoside, may be decreased by antineoplastic agents such as Trimetrexate. Liquid forms of Digoxin do not appear to be significantly affected. Monitor Digoxin tablet efficacy if Trimetrexate therapy is initiated, discontinued or if the dose is altered. (source: Drug Bank)
trimetrexate - digoxin The absorption of Digoxin, a cardiac glycoside, may be decreased by antineoplastic agents such as Trimetrexate. Liquid forms of Digoxin do not appear to be significantly affected. Monitor Digoxin tablet efficacy if Trimetrexate therapy is initiated, discontinued or if the dose is altered. (source: Drug Bank)
verapamil - digoxin Verapamil may increase the serum concentration of Digoxin by decreasing its metabolism and clearance. Monitor for changes in the therapeutic/adverse effects of Digoxin if Verpamail is initiated, discontinued or dose changed. (source: Drug Bank)
voriconazole - digoxin Voriconazole may increase the serum concentration of digoxin. Monitor for increased serum concentrations and toxic effects of digoxin if voriconazole is initiated or dose increased. (source: Drug Bank)

Curated Information ?

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
May Prevent
Contraindicated With

Publications related to digoxin: 34

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Development of Human Membrane Transporters: Drug Disposition and Pharmacogenetics. Clinical pharmacokinetics. 2015. Mooij Miriam G, et al. PubMed
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Evaluation of felodipine as a potential perpetrator of pharmacokinetic drug-drug interactions. European journal of clinical pharmacology. 2014. Snyder Ben D, et al. PubMed
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ABCB1 single nucleotide polymorphisms (1236C>T, 2677G>T, and 3435C>T) do not affect transport activity of human P-glycoprotein. Pharmacogenetics and genomics. 2013. Dickens David, et al. PubMed
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Pharmacogenetics and healthcare outcomes in patients with chronic heart failure. European journal of clinical pharmacology. 2012. Kim Kye-Min, et al. PubMed
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Complex drug interactions of the HIV protease inhibitors 3: effect of simultaneous or staggered dosing of digoxin and ritonavir, nelfinavir, rifampin, or bupropion. Drug metabolism and disposition: the biological fate of chemicals. 2012. Kirby Brian J, et al. PubMed
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Transporter-mediated drug-drug interactions. Pharmacogenomics. 2011. Müller Fabian, et al. PubMed
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Very important pharmacogene summary: ABCB1 (MDR1, P-glycoprotein). Pharmacogenetics and genomics. 2011. Hodges Laura M, et al. PubMed
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The impact of thyroid disease on the regulation, expression, and function of ABCB1 (MDR1/P glycoprotein) and consequences for the disposition of digoxin. Clinical pharmacology and therapeutics. 2010. Burk O, et al. PubMed
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Selectivity of digitalis glycosides for isoforms of human Na,K-ATPase. The Journal of biological chemistry. 2010. Katz Adriana, et al. PubMed
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A Phenotype-Genotype Approach to Predicting CYP450 and P-Glycoprotein Drug Interactions With the Mixed Inhibitor/Inducer Tipranavir/Ritonavir. Clinical pharmacology and therapeutics. 2010. Dumond J B, et al. PubMed
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Demonstrating the pharmacogenetic effects of angiotensin-converting enzyme inhibitors on long-term prognosis of diastolic heart failure. The pharmacogenomics journal. 2010. Wu C-K, et al. PubMed
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Genetic influences on the pharmacokinetics of orally and intravenously administered digoxin as exhibited by monozygotic twins. Clinical pharmacology and therapeutics. 2009. Birkenfeld A L, et al. PubMed
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Macrolide-induced digoxin toxicity: a population-based study. Clinical pharmacology and therapeutics. 2009. Gomes T, et al. PubMed
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Drug-drug interactions mediated through P-glycoprotein: clinical relevance and in vitro-in vivo correlation using digoxin as a probe drug. Clinical pharmacology and therapeutics. 2009. Fenner K S, et al. PubMed
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Effects of pregnancy on CYP3A and P-glycoprotein activities as measured by disposition of midazolam and digoxin: a University of Washington specialized center of research study. Clinical pharmacology and therapeutics. 2008. Hebert M F, et al. PubMed
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Structure, function and regulation of P-glycoprotein and its clinical relevance in drug disposition. Xenobiotica; the fate of foreign compounds in biological systems. 2008. Zhou S-F. PubMed
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Xenobiotic transporters of the human organic anion transporting polypeptides (OATP) family. Xenobiotica; the fate of foreign compounds in biological systems. 2008. Hagenbuch B, et al. PubMed
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Common ATP-binding cassette B1 variants are associated with increased digoxin serum concentration. Pharmacogenetics and genomics. 2008. Aarnoudse Albert-Jan L H J, et al. PubMed
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Influence of SLCO1B3 gene polymorphism on the pharmacokinetics of digoxin in terminal renal failure. Drug metabolism and pharmacokinetics. 2008. Tsujimoto Masayuki, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Impact of MDR1 haplotypes derived from C1236T, G2677T/A and C3435T on the pharmacokinetics of single-dose oral digoxin in healthy Chinese volunteers. Pharmacology. 2008. Xu Ping, et al. PubMed
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Modelling the influence of MDR1 polymorphism on digoxin pharmacokinetic parameters. European journal of clinical pharmacology. 2007. Comets Emmanuelle, et al. PubMed
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Effect of ABCB1 (MDR1) 3435C >T and 2677G >A,T polymorphisms and P-glycoprotein inhibitors on salivary digoxin secretion in congestive heart failure patients. Pharmacological reports : PR. 2007. Bartnicka Lilianna, et al. PubMed
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Meta-analysis of the influence of MDR1 C3435T polymorphism on digoxin pharmacokinetics and MDR1 gene expression. British journal of clinical pharmacology. 2005. Chowbay Balram, et al. PubMed
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Isolation and characterization of a digoxin transporter and its rat homologue expressed in the kidney. Proceedings of the National Academy of Sciences of the United States of America. 2004. Mikkaichi Tsuyoshi, et al. PubMed
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Digoxin pharmacokinetics and MDR1 genetic polymorphisms. European journal of clinical pharmacology. 2003. Verstuyft Céline, et al. PubMed
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MDR1 genotype-related duodenal absorption rate of digoxin in healthy Japanese subjects. Pharmaceutical research. 2003. Morita Yoshinori, et al. PubMed
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The Na, K-ATPase in the failing human heart. Cardiovascular research. 2003. Schwinger Robert H G, et al. PubMed
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MDR1 genotypes do not influence the absorption of a single oral dose of 1 mg digoxin in healthy white males. British journal of clinical pharmacology. 2002. Gerloff Thomas, et al. PubMed
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Significant genetic linkage of MDR1 polymorphisms at positions 3435 and 2677: functional relevance to pharmacokinetics of digoxin. Pharmaceutical research. 2002. Horinouchi Masanori, et al. PubMed
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Role of human MDR1 gene polymorphism in bioavailability and interaction of digoxin, a substrate of P-glycoprotein. Clinical pharmacology and therapeutics. 2002. Kurata Yasuo, et al. PubMed
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MDR1 genotype-related pharmacokinetics of digoxin after single oral administration in healthy Japanese subjects. Pharmaceutical research. 2001. Sakaeda T, et al. PubMed
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Functional polymorphisms of the human multidrug-resistance gene: multiple sequence variations and correlation of one allele with P-glycoprotein expression and activity in vivo. Proceedings of the National Academy of Sciences of the United States of America. 2000. Hoffmeyer S, et al. PubMed
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Isolation of a multispecific organic anion and cardiac glycoside transporter from rat brain. Proceedings of the National Academy of Sciences of the United States of America. 1997. Noé B, et al. PubMed
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Digitalis and the Na+,K(+)-ATPase. Heart disease and stroke : a journal for primary care physicians. 1993. Medford R M. PubMed

LinkOuts

Web Resource:
Wikipedia
National Drug Code Directory:
62584-989-01
DrugBank:
DB00390
ChEBI:
4551
KEGG Compound:
C06956
KEGG Drug:
D00298
PubChem Compound:
30322
PubChem Substance:
172469
Drugs Product Database (DPD):
2242323
BindingDB:
50115625
Therapeutic Targets Database:
DAP000744

Clinical Trials

These are trials that mention digoxin and are related to either pharmacogenetics or pharmacogenomics.

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