What the FDA labels say about taking them together
Digoxin and tramadol
Tramadol's FDA label of March 5, 2026 names digoxin in its drug interactions section; the digoxin labels PlainMeds reads (3) do not name tramadol. The tramadol label: “Postmarketing surveillance of tramadol has revealed rare reports of digoxin toxicity.”
Check it at the source: the digoxin FDA label on DailyMed (effective December 5, 2024, Advanz Pharma (US) Corp.); the tramadol FDA label on DailyMed (effective March 5, 2026, Lupin Pharmaceuticals, Inc.).
What does the digoxin label say about tramadol?
Digoxin's label (effective December 5, 2024) and its 2 other brand-application labels do not name tramadol in these sections. A label lists what its studies and reports found; it is not a complete list.
Source: FDA drug label (LANOXIN), Advanz Pharma (US) Corp., effective December 5, 2024 (SPL set d91e3646-4c63-4512-ab22-db39c085c4dc), via openFDA; the full label on DailyMed
What does the tramadol label say about digoxin?
Tramadol label, drug interactionsClinical Impact: Post-marketing surveillance of tramadol has revealed rare reports of digoxin toxicity. Intervention: Evaluate patients at frequent intervals for signs of digoxin toxicity and adjust the dosage of digoxin as needed.
Tramadol Hydrochloride label (TruPharma, LLC, January 25, 2023), drug interactionsClinical Impact: Postmarketing surveillance of tramadol has revealed rare reports of digoxin toxicity. Intervention: Follow patients for signs of digoxin toxicity and adjust dosage of digoxin as needed.
Source: FDA drug label (Tramadol Hydrochloride Extended-Release, NDA022370), Trigen Laboratories, LLC, effective January 23, 2026 (SPL set c0bc7218-3fd0-4646-96f4-25355fc84aa9), via openFDA
Source: FDA drug label (Tramadol Hydrochloride, NDA214044), TruPharma, LLC, effective January 25, 2023 (SPL set aea56ff9-94ac-47a8-8f15-8790d538973b), via openFDA
Source: FDA drug label (TRAMADOL HYDROCHLORIDE), Lupin Pharmaceuticals, Inc., effective March 5, 2026 (SPL set 46bb9ae6-3ee8-463c-badb-c7a45a89b84b), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Digoxin | Tramadol | |
|---|---|---|
| Labeled for | Heart failure, Atrial fibrillation | Pain |
| Boxed warning | No | Yes |
| Pharmacy cost (NADAC) | $0.133 per tablet 125 mcg tablet | $0.0248 per tablet 50 mg tablet |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once