NutriStack
Amiodarone and Digoxin, a caution.
Amiodarone increases digoxin levels by 70-100% through inhibition of P-glycoprotein and reduction of renal and non-renal clearance. This can cause potentially fatal digoxin toxicity with cardiac arrhythmias.
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
- Amiodarone and Digoxin
- Pair type
- Caution
- Evidence (highest tier)
- Strong
- Source citations
- 1 source
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Strong evidence
Caution
What is happening. Amiodarone increases digoxin levels by 70-100% through inhibition of P-glycoprotein and reduction of renal and non-renal clearance. This can cause potentially fatal digoxin toxicity with cardiac arrhythmias.
Mechanism. Amiodarone inhibits P-glycoprotein (MDR1)-mediated renal tubular secretion and biliary excretion of digoxin, and reduces its volume of distribution, resulting in approximately doubled digoxin serum levels.
Recommendation. Reduce digoxin dose by 50% when starting amiodarone. Monitor digoxin levels closely. Watch for toxicity signs (nausea, visual changes, bradycardia, arrhythmias).
Stack Score
How this pair moves the number.
Effect on the composite score
If both Amiodarone and Digoxin are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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