Minor
Suspected
Description
Valsartan may slightly increase digoxin plasma levels by reducing its renal clearance; the interaction is generally modest.
Mechanism
Angiotensin II promotes renal tubular secretion of digoxin; ARB-mediated angiotensin II blockade may reduce this secretion, marginally raising digoxin levels.
Clinical Significance
Small increase in digoxin exposure; rarely clinically significant unless patient is already at the upper end of the therapeutic range.
Management
Monitor digoxin levels when initiating valsartan in digitalized patients; adjust dose if levels exceed 1.2 ng/mL.