Alprazolam and Digoxin Interaction
Drug interaction information between Alprazolam and Digoxin.
Alprazolam and Digoxin have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Alprazolam and Digoxin. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
How They Interact
Alprazolam can cause digoxin levels to build up in the body, which can lead to dangerous side effects. This happens more often in patients over the age of 65.
What To Do
Your doctor should check your digoxin blood levels before you start taking alprazolam.
FDA Label Information
( 7.1 ) Use with Digoxin: Increase the risk of digoxin toxicity. Digoxin Clinical implication Increased digoxin concentrations have been reported when alprazolam was given, especially in geriatric patients (>65 years of age). Prevention or management In patients on digoxin therapy, measure serum digoxin concentrations before initiating alprazolam.
Alprazolam Also Interacts With
- Ketoconazole moderate
- Clarithromycin moderate
- Itraconazole moderate
- Aprepitant moderate
- Fluoxetine moderate
Digoxin Also Interacts With
- Nicardipine major
- Posaconazole major
- Sotalol moderate
- Dofetilide moderate
- Ivabradine moderate
Frequently Asked Questions
Can I take Alprazolam and Digoxin together?
This is a moderate interaction. Your doctor should check your digoxin blood levels before you start taking alprazolam.
How serious is the interaction between Alprazolam and Digoxin?
This interaction is classified as "moderate" severity by the FDA. Moderate interactions may worsen your condition or change how your medications work.
Why do Alprazolam and Digoxin interact?
Alprazolam can cause digoxin levels to build up in the body, which can lead to dangerous side effects. This happens more often in patients over the age of 65.
Understanding the Alprazolam and Digoxin Interaction
FDA-approved prescribing information for these two drugs flags their combination as a moderate-severity interaction. Alprazolam belongs to the Benzodiazepine class and Digoxin belongs to the Cardiac Glycoside class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Alprazolam can cause digoxin levels to build up in the body, which can lead to dangerous side effects. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Alprazolam has 27 total documented interactions on file in this dataset, and Digoxin has 120. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: Your doctor should check your digoxin blood levels before you start taking alprazolam. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Alprazolam or Digoxin based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.