Drug General Information (ID: DDIIZQY769)
Drug Name			Digitoxin		Drug Info		Tofacitinib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiarrhythmic Agents				Antirheumatics
Structure

Mechanism of Digitoxin-Tofacitinib Interaction (Severity Level: Moderate)
Increased risk of bradycardia Click to Show/Hide Mechanism Graph
Drug Name		Digitoxin				Tofacitinib
Mechanism		Bradycardia				Bradycardia
Key Mechanism Factor 1
		Factor Name		Bradycardia
		Factor Description		Bradycardia is a slow heart rate in which the heart beats less than 60 times per minute. If the heart rate is very slow and the heart is not pumping enough oxygen-rich blood to the body, and you may feel dizzy, very tired or weak, and short of breath.
Mechanism Description		Increased risk of bradycardia by the combination of Digitoxin and Tofacitinib

Recommended Action
Management		According to the manufacturer, concomitant use of tofacitinib with other agents that lower heart rate and/or prolong the PR interval should be avoided when possible. Caution is advised if concomitant use is necessary, particularly in patients with known conduction problems or severe cardiac disease. An ECG should be considered in these patients before initiating concomitant therapy and after titration to steady-state. Patients should be advised to notify their physician if they experience dizziness, lightheadedness, fainting, or irregular heartbeats.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	Canadian Pharmacists Association "e-CPS."