What the FDA labels say about taking them together
Digoxin and verapamil
Digoxin's FDA label (Lanoxin) of October 17, 2025 names verapamil in its drug interactions section, and verapamil's label names digoxin too. The verapamil label: “Digitalis Consider reducing digoxin dose when verapamil and digoxin are to be given together.”
Check it at the source: the digoxin FDA label on DailyMed (effective December 5, 2024, Advanz Pharma (US) Corp.); the verapamil FDA label on DailyMed (effective April 6, 2026, Zydus Pharmaceuticals (USA) Inc.).
What does the digoxin label say about verapamil?
Lanoxin label (Covis Pharma US, Inc, October 17, 2025), drug interactionsVerapamil; NA; 24%; Measure serum digoxin concentrations before initiating concomitant drugs. Reduce digoxin concentrations by decreasing the dose by approximately 15-30% or by modifying the dosing frequency and continue monitoring.
Source: FDA drug label (Lanoxin, NDA009330), Covis Pharma US, Inc, effective October 17, 2025 (SPL set 9ec84cac-6ecc-43dc-8006-6ccc029e2707), via openFDA
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 verapamil label say about digoxin?
Verapamil label, drug interactionsClinical use of verapamil in digitalized patients has shown the combination to be well tolerated if digoxin doses are properly adjusted.
Verapamil label, warningsPatients with milder ventricular dysfunction should, if possible, be controlled with optimum doses of digitalis and/or diuretics before verapamil treatment. (Note interactions with digoxin under PRECAUTIONS ) Hypotension:
Verapamil Hydrochloride label (Wilshire Pharmaceuticals, Inc., November 27, 2024), drug interactionsDigitalis Consider reducing digoxin dose when verapamil and digoxin are to be given together.
Verapamil Hydrochloride label (Wilshire Pharmaceuticals, Inc., November 27, 2024), drug interactionsDRUG INTERACTIONS CYP3A4 inhibitors increase verapamil levels ( 7.1 ) CYP3A4 inducers decrease verapamil levels ( 7.1 ) If simvastatin is co-administered with verapamil, do not exceed doses greater than 10 mg daily of simvastatin ( 7.2 ) If lovastatin is co-administered with verapamil, do not exceed doses greater than 40 mg daily of lovastatin ( 7.2 ) Grapefruit juice may significantly increase verapamil levels ( 7.3 ) Beta blockers: reports of excess bradycardia and AV block, including complete heart block; monitor closely ( 7.4 ) Digoxin levels can increase by 50 to 75%; reduce digoxin dose ( 7.5 ) Alcohol elimination inhibited resulting in elevated ethanol levels
Source: FDA drug label (Verapamil Hydrochloride, NDA019614), Wilshire Pharmaceuticals, Inc., effective November 27, 2024 (SPL set f9399858-fd7a-4b73-8759-3e5bf3af2666), via openFDA
Source: FDA drug label (Verapamil Hydrochloride, NDA020943), Wilshire Pharmaceuticals, Inc., effective November 27, 2024 (SPL set 5f665d08-e1e4-422a-88c2-d8834abf9e1a), via openFDA
Source: FDA drug label (Verapamil hydrochloride), Zydus Pharmaceuticals (USA) Inc., effective April 6, 2026 (SPL set e19ab8d8-dae5-489d-9805-7e7407bea06d), 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 | Verapamil | |
|---|---|---|
| Labeled for | Heart failure, Atrial fibrillation | High blood pressure, Atrial fibrillation, Angina |
| Boxed warning | No | No |
| Pharmacy cost (NADAC) | $0.133 per tablet 125 mcg tablet | $0.191 per tablet 180 mg tablet |
| Shortage now | No current entry | A presentation being discontinued |
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