NutriStack
Activated Charcoal and Digoxin, timing-sensitive.
Activated charcoal binds digoxin in the gastrointestinal tract and can sharply reduce absorption when taken near a dose. Because digoxin has a narrow therapeutic window, reduced absorption can worsen atrial fibrillation rate control or heart failure symptoms. Charcoal is used medically for selected poisonings and is not a routine detox supplement for people taking digoxin.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Activated Charcoal and Digoxin
- Pair type
- Timing Sensitive
- Evidence (highest tier)
- Strong
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored timing-sensitive row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Timing Sensitive · Strong evidence
Timing Sensitive
What is happening. Activated charcoal binds digoxin in the gastrointestinal tract and can sharply reduce absorption when taken near a dose. Because digoxin has a narrow therapeutic window, reduced absorption can worsen atrial fibrillation rate control or heart failure symptoms. Charcoal is used medically for selected poisonings and is not a routine detox supplement for people taking digoxin.
Mechanism. Activated charcoal nonselectively adsorbs digoxin in the gut, reducing drug available for absorption and potentially interrupting intestinal recirculation. This lowers systemic digoxin exposure when timing overlaps.
Recommendation. Avoid activated charcoal supplements while taking digoxin unless a clinician specifically directs it. If a one-time charcoal dose is unavoidable outside an emergency setting, separate it from digoxin by at least 6 hours and tell your prescriber if palpitations, swelling, or shortness of breath worsen.
Minimum separation. 360
Sources (2)
- Neuvonen PJ, Kivisto K, Hirvisalo EL. Effects of resins and activated charcoal on the absorption of digoxin, carbamazepine and frusemide. Br J Clin Pharmacol. 1988;25(2):229-233. PMID 3358884
- Neuvonen PJ, Elfving SM, Elonen E. Reduction of absorption of digoxin, phenytoin and aspirin by activated charcoal in man. Eur J Clin Pharmacol. 1978;13(3):213-218. PMID 668776
Stack Score
How this pair moves the number.
Effect on the composite score
If both Activated Charcoal and Digoxin are in the same stack, this pair applies −5 to your Stack Score (per scored timing-sensitive row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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