NutriStack
Digoxin and Vitamin D3, a caution.
High-dose vitamin D3 can cause hypercalcemia, and hypercalcemia can make digoxin-related rhythm problems more likely. This is not a routine-dose vitamin D issue for most people, but it becomes clinically important with high-dose D3, accidental overuse, kidney disease, granulomatous disease, or concurrent calcium supplements. Symptoms can include nausea, confusion, weakness, visual changes, palpitations, or fainting.
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
- Digoxin and Vitamin D3
- Pair type
- Caution
- Evidence (highest tier)
- Moderate
- Source citations
- 3 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Moderate evidence
Caution
What is happening. High-dose vitamin D3 can cause hypercalcemia, and hypercalcemia can make digoxin-related rhythm problems more likely. This is not a routine-dose vitamin D issue for most people, but it becomes clinically important with high-dose D3, accidental overuse, kidney disease, granulomatous disease, or concurrent calcium supplements. Symptoms can include nausea, confusion, weakness, visual changes, palpitations, or fainting.
Mechanism. Vitamin D3 toxicity increases intestinal calcium absorption and can produce hypercalcemia. Hypercalcemia increases myocardial excitability and can potentiate digoxin's sodium-potassium ATPase effects, raising susceptibility to conduction disturbances and arrhythmias.
Recommendation. Avoid high-dose vitamin D3 while taking digoxin unless your clinician is monitoring calcium and kidney function. If you need vitamin D repletion, use the prescribed dose and ask when calcium should be rechecked. Seek urgent care for fainting, new irregular heartbeat, severe weakness, confusion, or persistent vomiting.
Sources (3)
- Vella A, Gerber TC, Hayes DL, Reeder GS. Digoxin, hypercalcaemia, and cardiac conduction. Postgrad Med J. 1999;75(887):554-556. PMID 10616693
- Galior K, Grebe S, Singh R. Development of Vitamin D Toxicity from Overcorrection of Vitamin D Deficiency: A Review of Case Reports. Nutrients. 2018;10(8):953. PMID 30042334
- Holick MF. Vitamin D Is Not as Toxic as Was Once Thought: A Historical and an Up-to-Date Perspective. Mayo Clin Proc. 2015;90(5):561-564. PMID 25939933
Stack Score
How this pair moves the number.
Effect on the composite score
If both Digoxin and Vitamin D3 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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