Drug General Information (ID: DDI9KS4Y50)
Drug Name			Calcifediol		Drug Info		Digitoxin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Vitamins				Antiarrhythmic Agents
Structure

Mechanism of Calcifediol-Digitoxin Interaction (Severity Level: Moderate)
Increased risk of other adverse reactions (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Calcifediol				Digitoxin
Mechanism		Potentiate the risk of digitalis toxicity				Digitalis glycosides
Key Mechanism Factor 1
		Factor Name		Adverse reactions
		Factor Description		An adverse reaction is an unexpected negative reaction to a medication or treatment that happens even when it's used correctly.
Mechanism Description		Increased risk of adverse reactions by the combination of Calcifediol and Digitoxin

Recommended Action
Management		Caution is advised if digitalis compounds are used concomitantly with vitamin D or vitamin D analogs. Serum digoxin, calcium, and phosphorus levels should be closely monitored, especially early in treatment during dosage adjustment. The serum calcium X phosphorus product should be maintained at less than 55 in patients with chronic kidney disease and should not be allowed to exceed 70 in any patient. An estimate of daily dietary calcium intake should be made and the intake adjusted when indicated. Patients should be advised to avoid an abrupt increase in dietary calcium intake, as it may trigger hypercalcemia, and to contact their physician if they experience early symptoms of vitamin D intoxication associated with hypercalcemia such as weakness, fatigue, headache, somnolence, vertigo, tinnitus, anorexia, nausea, vomiting, constipation, dry mouth, metallic taste, muscle pain, bone pain, ataxia, and hypotonia.

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2	Product Information. Zemplar (paricalcitol). Abbott Pharmaceutical, Abbott Park, IL.
3	Therapeutic Research Faculty "Natural Medicines Comprehensive Database."