Which medication is known to increase digoxin levels?

Amiodarone is known to increase digoxin levels due to its pharmacokinetic interactions. This medication can inhibit the P-glycoprotein transporter, which plays a crucial role in the elimination of digoxin from the body. As a result, when a patient is taking amiodarone alongside digoxin, the concentration of digoxin can rise, potentially leading to digoxin toxicity.

This interaction is particularly significant because digoxin has a narrow therapeutic index, meaning that small increases in its blood levels can lead to adverse effects. Patients who are on both amiodarone and digoxin require careful monitoring of their digoxin levels to avoid toxicity and associated complications, such as nausea, vomiting, and arrhythmias.

In contrast, the other medications mentioned do not have a significant effect on digoxin levels. Cholestyramine can bind to digoxin in the gastrointestinal tract, potentially reducing its absorption rather than increasing its levels. Ibuprofen and aspirin, while they may have other interactions or effects, do not notably affect digoxin levels in a way that poses a risk similar to that of amiodarone. Understanding these interactions is crucial for nurses and healthcare providers to ensure safe and effective medication management in patients with heart failure who are prescribed