Can you take Lanoxicaps with Levothyroxine / liothyronine?
1 drug interaction and 33 additional warnings found for the following 2 drugs:
- Lanoxicaps (digoxin)
- levothyroxine/liothyronine
Drug interactions
Moderate drug interactions
Moderate:
digoxin liotrix
Applies to: Lanoxicaps (digoxin) and levothyroxine / liothyronine
Before taking liotrix, tell your doctor if you also use digoxin. You may need dose adjustments or special tests in order to safely take both medications together.
This combination may cause a decrease in digoxin levels. The dosage of digoxin may need to be increased.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
liotrix Food/Lifestyle
Applies to: levothyroxine / liothyronine
The timing of meals relative to your oral liotrix dose can affect the absorption of the medication.
Therefore, liotrix should be taken on a consistent schedule with regard to time of day and relation to meals to avoid large fluctuations in blood levels, which may alter its effects.
In addition, absorption of liotrix may be decreased and/or delayed by foods such as:
- soybean flour
- cotton seed meal
- walnuts
- dietary fiber
- calcium
- calcium fortified juices
- grapefruit or grapefruit juice
These foods should be avoided within several hours of dosing if possible.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate:
liotrix multivitamins with minerals
Applies to: levothyroxine / liothyronine
Using multivitamins with minerals together with liotrix may decrease the effects of liotrix.
You should separate the administration of liotrix and multivitamins with minerals by at least 4 hours.
If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Minor food/lifestyle interactions
Minor:
digoxin Food/Lifestyle
Applies to: Lanoxicaps (digoxin)
Administration of digoxin with a high-fiber meal has been shown to decrease its bioavailability by almost 20%. Fiber can sequester up to 45% of the drug when given orally. Patients should be advised to maintain a regular diet without significant fluctuation in fiber intake while digoxin is being titrated.
Grapefruit juice may modestly increase the plasma concentrations of digoxin. The mechanism is increased absorption of digoxin due to mild inhibition of intestinal P-glycoprotein by certain compounds present in grapefruits. In 12 healthy volunteers, administration of grapefruit juice with and 30 minutes before, as well as 3.5, 7.5, and 11.5 hours after a single digoxin dose (0.5 mg) increased the mean area under the plasma concentration-time curve (AUC) of digoxin by just 9% compared to administration with water. Moreover, P-glycoprotein genetic polymorphism does not appear to influence the magnitude of the effects of grapefruit juice on digoxin. Thus, the interaction is unlikely to be of clinical significance.
The information above is from our professional interaction data. Consumer information is not available for this interaction.
Disease interactions
30 potential interactions Applies to: 28 conditions, including High Blood Pressure, Underactive Thyroid, Heart Attack, Seizures, and Diarrhea.
Adrenal Insufficiency
Major:
levothyroxine / liothyronine
The liotrix in levothyroxine / liothyronine has a major potential interaction with Adrenal Insufficiency.
The use of thyroid hormones is contraindicated in patients with uncorrected adrenal insufficiency. Thyroid hormones increase tissue demand for adrenocortical hormones and may precipitate acute adrenal crisis. In patients with controlled adrenal insufficiency or other endocrine disorders, therapy for these concomitant disorders may need to be adjusted following thyroid replacement, since hypothyroidism often obscure or diminish the signs and symptoms of these conditions. Clinical monitoring of thyroid and adrenal function as well as any other appropriate endocrine function is recommended during thyroid hormone therapy.
Cardiomyopathy
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Cardiomyopathy.
Patients with heart failure associated with preserved left ventricular systolic function, such as in restrictive cardiomyopathy, constrictive pericarditis, amyloid heart disease and acute cor pulmonale, may be particularly susceptible to experience decrease cardiac output. Therapy with digoxin should be administered cautiously in such patients. Patients with idiopathic hypertrophic subaortic stenosis may have worsening of the outflow obstruction due to the inotropic effects of digoxin.
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Cardiomyopathy.
Digoxin can rarely precipitate vasoconstriction and may promote the development of cytokines; therefore, should be avoided in patients with myocarditis.
Constrictive Pericarditis
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Constrictive Pericarditis.
Patients with heart failure associated with preserved left ventricular systolic function, such as in restrictive cardiomyopathy, constrictive pericarditis, amyloid heart disease and acute cor pulmonale, may be particularly susceptible to experience decrease cardiac output. Therapy with digoxin should be administered cautiously in such patients. Patients with idiopathic hypertrophic subaortic stenosis may have worsening of the outflow obstruction due to the inotropic effects of digoxin.
Cor Pulmonale
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Cor Pulmonale.
Patients with heart failure associated with preserved left ventricular systolic function, such as in restrictive cardiomyopathy, constrictive pericarditis, amyloid heart disease and acute cor pulmonale, may be particularly susceptible to experience decrease cardiac output. Therapy with digoxin should be administered cautiously in such patients. Patients with idiopathic hypertrophic subaortic stenosis may have worsening of the outflow obstruction due to the inotropic effects of digoxin.
Diabetes Insipidus
Moderate:
levothyroxine / liothyronine
The liotrix in levothyroxine / liothyronine has a moderate potential interaction with Diabetes Insipidus.
Since hypothyroidism often obscure or diminish the signs and symptoms of endocrine disorders such as diabetes mellitus or diabetes insipidus, thyroid replacement therapy may aggravate the intensity of symptoms associated with these conditions. Patients with endocrine disorders should be monitored more closely during thyroid hormone therapy, and their medication regimen adjusted accordingly. If thyroid medication is later discontinued, a downward readjustment of insulin or oral hypoglycemic agent may be necessary in patients with diabetes mellitus to avoid hypoglycemia.
Diabetes Mellitus
Moderate:
levothyroxine / liothyronine
The liotrix in levothyroxine / liothyronine has a moderate potential interaction with Diabetes Mellitus.
Since hypothyroidism often obscure or diminish the signs and symptoms of endocrine disorders such as diabetes mellitus or diabetes insipidus, thyroid replacement therapy may aggravate the intensity of symptoms associated with these conditions. Patients with endocrine disorders should be monitored more closely during thyroid hormone therapy, and their medication regimen adjusted accordingly. If thyroid medication is later discontinued, a downward readjustment of insulin or oral hypoglycemic agent may be necessary in patients with diabetes mellitus to avoid hypoglycemia.
Diarrhea
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Diarrhea.
Potassium and/or magnesium depletion sensitizes the myocardium to digoxin. In patients with hypokalemia or hypomagnesemia, digoxin toxicity may occur despite serum drug concentrations below 2.0 ng/mL. Therapy with digoxin should be administered cautiously in patients with or predisposed to potassium and/or magnesium deficiency, including patients on diuretic therapy; those with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; those with malnutrition; and renal dialysis patients. Electrolyte imbalances should be corrected prior to initiation of treatment. Serum potassium and magnesium concentrations should be monitored during therapy.
Electrolyte Abnormalities
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Electrolyte Abnormalities.
Potassium and/or magnesium depletion sensitizes the myocardium to digoxin. In patients with hypokalemia or hypomagnesemia, digoxin toxicity may occur despite serum drug concentrations below 2.0 ng/mL. Therapy with digoxin should be administered cautiously in patients with or predisposed to potassium and/or magnesium deficiency, including patients on diuretic therapy; those with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; those with malnutrition; and renal dialysis patients. Electrolyte imbalances should be corrected prior to initiation of treatment. Serum potassium and magnesium concentrations should be monitored during therapy.
Heart Attack
Moderate:
Lanoxicaps
The digoxin in Lanoxicaps has a moderate potential interaction with Heart Attack.
The use of inotropic drugs in some patients with acute myocardial infarction may lead to increases in myocardial oxygen demand and lead to ischemia. Therapy with digoxin should be administered cautiously in these patients.
Heart Block
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Heart Block.
Digoxin slows sinoatrial and AV conduction, prolonging the PR interval. When treated with digoxin, patients with preexisting sinus node disease may develop severe sinus bradycardia or sinoatrial block, and patients with incomplete AV block may progress to advanced or complete heart block. In such patients, consideration should be given to the insertion of a pacemaker prior to initiating treatment with digoxin. Digoxin may be administered to patients with complete, stable AV block who have congestive heart failure, provided the block was not induced by cardiac glycosides.
Heart Disease
Major:
levothyroxine / liothyronine
The liotrix in levothyroxine / liothyronine has a major potential interaction with Heart Disease.
Thyroid hormones cause increases in myocardial contractility and heart rate as a result of increased metabolic demands and oxygen consumption. Therapy with thyroid hormones should be administered cautiously and initiated at reduced dosages in patients with cardiovascular disorders such as angina, coronary artery disease, and hypertension. Clinical monitoring of cardiovascular function is recommended. If chest pain or exacerbation of cardiovascular disease occurs, the dosage of thyroid hormone should be reduced, even at the expense of achieving euthyroid state. Thyroid hormones should not be administered to patients with an acute myocardial infarction that is not complicated by hypothyroidism.
Hemodialysis
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Hemodialysis.
Potassium and/or magnesium depletion sensitizes the myocardium to digoxin. In patients with hypokalemia or hypomagnesemia, digoxin toxicity may occur despite serum drug concentrations below 2.0 ng/mL. Therapy with digoxin should be administered cautiously in patients with or predisposed to potassium and/or magnesium deficiency, including patients on diuretic therapy; those with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; those with malnutrition; and renal dialysis patients. Electrolyte imbalances should be corrected prior to initiation of treatment. Serum potassium and magnesium concentrations should be monitored during therapy.
High Blood Pressure
Major:
levothyroxine / liothyronine
The liotrix in levothyroxine / liothyronine has a major potential interaction with High Blood Pressure.
Thyroid hormones cause increases in myocardial contractility and heart rate as a result of increased metabolic demands and oxygen consumption. Therapy with thyroid hormones should be administered cautiously and initiated at reduced dosages in patients with cardiovascular disorders such as angina, coronary artery disease, and hypertension. Clinical monitoring of cardiovascular function is recommended. If chest pain or exacerbation of cardiovascular disease occurs, the dosage of thyroid hormone should be reduced, even at the expense of achieving euthyroid state. Thyroid hormones should not be administered to patients with an acute myocardial infarction that is not complicated by hypothyroidism.
Hyperaldosteronism
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Hyperaldosteronism.
Potassium and/or magnesium depletion sensitizes the myocardium to digoxin. In patients with hypokalemia or hypomagnesemia, digoxin toxicity may occur despite serum drug concentrations below 2.0 ng/mL. Therapy with digoxin should be administered cautiously in patients with or predisposed to potassium and/or magnesium deficiency, including patients on diuretic therapy; those with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; those with malnutrition; and renal dialysis patients. Electrolyte imbalances should be corrected prior to initiation of treatment. Serum potassium and magnesium concentrations should be monitored during therapy.
Hypercalcemia
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Hypercalcemia.
Calcium and digoxin have additive inotropic effects. Therefore, hypercalcemia from any cause will predispose patients to digoxin toxicity and serious arrhythmias. Hypercalcemia should be corrected prior to initiating treatment with digoxin, and serum calcium levels should be monitored during therapy.
Hyperthyroidism
Major:
levothyroxine / liothyronine
The liotrix in levothyroxine / liothyronine has a major potential interaction with Hyperthyroidism.
The use of thyroid hormones is contraindicated in patients with untreated thyrotoxicosis of any etiology, since thyroid hormones may exacerbate the condition.
Moderate:
Lanoxicaps
The digoxin in Lanoxicaps has a moderate potential interaction with Hyperthyroidism.
Heart failure and/or atrial arrhythmias resulting from hypermetabolic or hyperdynamic states such as hyperthyroidism, hypoxia, or arteriovenous shunt are best managed by treating the underlying condition. Atrial arrhythmias associated with hypermetabolic states are particularly refractory to digoxin, possibly due to altered pharmacokinetics. Specifically, the apparent volume of distribution and renal elimination of the drug may be increased, resulting in lower serum concentrations. Therapy with digoxin should be administered cautiously in patients with hyperthyroidism. Serum digoxin levels should be monitored regularly and dosage adjustments may be required secondary to changes in their thyroid condition.
Hypocalcemia
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Hypocalcemia.
Hypocalcemia can nullify the effects of digoxin. The drug may be ineffective in hypocalcemic patients until serum calcium levels are restored to normal. Restore serum calcium levels prior to initiating therapy with digoxin to obtain maximum results when using digoxin.
Hypokalemia
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Hypokalemia.
Potassium and/or magnesium depletion sensitizes the myocardium to digoxin. In patients with hypokalemia or hypomagnesemia, digoxin toxicity may occur despite serum drug concentrations below 2.0 ng/mL. Therapy with digoxin should be administered cautiously in patients with or predisposed to potassium and/or magnesium deficiency, including patients on diuretic therapy; those with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; those with malnutrition; and renal dialysis patients. Electrolyte imbalances should be corrected prior to initiation of treatment. Serum potassium and magnesium concentrations should be monitored during therapy.
Magnesium Imbalance
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Magnesium Imbalance.
Potassium and/or magnesium depletion sensitizes the myocardium to digoxin. In patients with hypokalemia or hypomagnesemia, digoxin toxicity may occur despite serum drug concentrations below 2.0 ng/mL. Therapy with digoxin should be administered cautiously in patients with or predisposed to potassium and/or magnesium deficiency, including patients on diuretic therapy; those with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; those with malnutrition; and renal dialysis patients. Electrolyte imbalances should be corrected prior to initiation of treatment. Serum potassium and magnesium concentrations should be monitored during therapy.
Malnourishment
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Malnourishment.
Potassium and/or magnesium depletion sensitizes the myocardium to digoxin. In patients with hypokalemia or hypomagnesemia, digoxin toxicity may occur despite serum drug concentrations below 2.0 ng/mL. Therapy with digoxin should be administered cautiously in patients with or predisposed to potassium and/or magnesium deficiency, including patients on diuretic therapy; those with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; those with malnutrition; and renal dialysis patients. Electrolyte imbalances should be corrected prior to initiation of treatment. Serum potassium and magnesium concentrations should be monitored during therapy.
Preexcitation Syndrome
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Preexcitation Syndrome.
Digoxin may enhance accessory pathway conduction in conditions such as the Wolff-Parkinson-White syndrome. Patients with Wolf-Parkinson-White syndrome that presents atrial fibrillation are at higher risk for ventricular fibrillation. Treatment with digoxin should be used with caution in these patients.
Renal Dysfunction
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Renal Dysfunction.
Digoxin is primarily eliminated by the kidney. Patients with renal impairment may be at increased risk for digoxin toxicity, including ventricular arrhythmias and AV conduction disturbances, due to decreased drug clearance. Therapy with digoxin should be administered cautiously in patients with impaired renal function. Dosage adjustments should be made according to product package labeling and patient attributes such as age, ideal body weight, and other concomitant disease states and medication usage. Dosage increments should be made very gradually, since the elimination half-life may be prolonged in these patients and a longer period of time is required to establish steady-state serum concentrations than normal. These patients should be monitored closely for manifestations of toxicity, and dosages further adjusted as necessary. If toxicity occurs, clinicians should be aware that the adverse effects may also be prolonged.
Seizures
Moderate:
levothyroxine / liothyronine
The liotrix in levothyroxine / liothyronine has a moderate potential interaction with Seizures.
Thyroid hormones may alter the seizure threshold. Seizures have been reported rarely following the initiation of levothyroxine therapy. Therapy with thyroid hormones should be administered cautiously in patients predisposed to seizures.
Sinus Node Dysfunction
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Sinus Node Dysfunction.
Digoxin slows sinoatrial and AV conduction, prolonging the PR interval. When treated with digoxin, patients with preexisting sinus node disease may develop severe sinus bradycardia or sinoatrial block, and patients with incomplete AV block may progress to advanced or complete heart block. In such patients, consideration should be given to the insertion of a pacemaker prior to initiating treatment with digoxin. Digoxin may be administered to patients with complete, stable AV block who have congestive heart failure, provided the block was not induced by cardiac glycosides.
Underactive Thyroid
Moderate:
Lanoxicaps
The digoxin in Lanoxicaps has a moderate potential interaction with Underactive Thyroid.
Hypothyroidism may reduce the requirements for digoxin due to decreased volume of distribution and plasma clearance of the drug. Therapy with digoxin should be initiated at lower dosages in patients with hypothyroidism to avoid toxicity. Serum digoxin levels should be monitored regularly and dosage adjustments may be required secondary to changes in thyroid condition.
Ventricular Arrhythmia
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Ventricular Arrhythmia.
The use of digoxin is contraindicated in patients with ventricular fibrillation. Digoxin toxicity is associated with adverse cardiac effects, including ventricular arrhythmias, which are most commonly seen in chronic toxicity. Digoxin-induced ventricular tachycardia is associated with a high mortality rate, since ventricular fibrillation or asystole may result. Therapy with digoxin should be administered cautiously in patients with frequent ventricular premature contractions or ventricular tachycardia, especially if these arrhythmias are not caused by heart failure.
Vitamin B1 Deficiency
Moderate:
Lanoxicaps
The digoxin in Lanoxicaps has a moderate potential interaction with Vitamin B1 Deficiency.
Patients with beri beri heart disease may fail to respond adequately to digoxin if the underlying thiamine deficiency is not treated concomitantly.
Vomiting
Major:
Lanoxicaps
The digoxin in Lanoxicaps has a major potential interaction with Vomiting.
Potassium and/or magnesium depletion sensitizes the myocardium to digoxin. In patients with hypokalemia or hypomagnesemia, digoxin toxicity may occur despite serum drug concentrations below 2.0 ng/mL. Therapy with digoxin should be administered cautiously in patients with or predisposed to potassium and/or magnesium deficiency, including patients on diuretic therapy; those with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; those with malnutrition; and renal dialysis patients. Electrolyte imbalances should be corrected prior to initiation of treatment. Serum potassium and magnesium concentrations should be monitored during therapy.
More resources
Lanoxicaps
A total of 474 drugs are known to interact with Lanoxicaps.
- Lanoxicaps is in the following drug classes: group V antiarrhythmics, inotropic agents.
- Lanoxicaps is used to treat the following conditions:
levothyroxine / liothyronine
A total of 222 drugs are known to interact with levothyroxine / liothyronine.
- Levothyroxine / liothyronine is in the drug class thyroid drugs.
- Levothyroxine / liothyronine is used to treat Underactive Thyroid.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.