AZOLES AND DIGOXIN

Itraconazole can cause a marked increase in digoxin levels (usually doubled, but a 6-fold increase was seen in one case). Toxicity may occur unless the digoxin dosage is suitably reduced. Voriconazole and posaconazole may interact similarly.
Monitor concurrent use for digoxin toxicity (e.g. bradycardia or nausea), taking
digoxin levels as necessary. Adjust the dose accordingly. Note that, based on the interaction with itraconazole, the manufacturer of posaconazole advises monitor- ing digoxin levels.
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