CALCIUM-CHANNEL BLOCKERS AND DIGOXIN - OTHER CALCIUM-CHANNEL BLOCKERS

Felodipine, gallopamil, lacidipine, lercanidipine, nicardipine and nisoldipine cause small increases in digoxin levels (maximum rise seen was about 30%, which was not considered clinically significant). The situation with nitrendipine is uncertain but it possibly causes only a small rise in digoxin levels. Serum digoxin levels are normally unchanged or increased only to a small extent by the concurrent use of nifedipine. However, one isolated study indicated that a 45% rise could occur.
Bear this interaction in mind if patients are treated with both drugs concurrently. The possibility of a serious interaction seems small, but if undesirable bradycardia or other symptoms of over-digitalisation occur consider taking digoxin levels.
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