International Journal of Clinical Pharmacy

, Volume 35, Issue 5, pp 673–676 | Cite as

Possible digoxin toxicity associated with concomitant ciprofloxacin therapy

  • Brady S. MoffettEmail author
  • Santiago O. Valdes
  • Jeffrey J. Kim
Case Report


Case (Description)

A 27 year old female with a complex history of congenital heart disease, cardiac surgery, heart failure, and arrhythmias was admitted for a Pseudomonas aeruginosa sternal wound infection and treated with intravenous antibiotics. After discharge and completion of an outpatient course of intravenous antibiotics, suppressive antibiotic therapy with ciprofloxacin was initiated. She presented to clinic with nausea and anorexia within a few days of addition of ciprofloxacin to her current regimen of medications, which included digoxin. The digoxin was discontinued, with all other medications remaining the same, and the symptoms resolved in 48 h. The dose of digoxin was restarted at 50 % of the previous dose with no further complications. The proposed cause of the nausea and anorexia was digoxin toxicity secondary to a drug–drug interaction with ciprofloxacin.


Patients receiving ciprofloxacin and digoxin should be monitored closely for the risk of digoxin toxicity.


Digoxin Ciprofloxacin Eubacterium lentum P-glycoprotein 


Conflicts of interest





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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Brady S. Moffett
    • 1
    Email author
  • Santiago O. Valdes
    • 2
  • Jeffrey J. Kim
    • 2
  1. 1.Department of PharmacyTexas Children’s HospitalHoustonUSA
  2. 2.Department of PediatricsBaylor College of MedicineHoustonUSA

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