arrhythmia
9 interactions related to arrhythmia
omeprazole + magnesium
Long-term omeprazole use (typically more than a year, occasionally sooner) can lower body magnesium, likely by impairing active intestinal magnesium transport through the TRPM6/TRPM7 channels. The FDA issued a formal Drug Safety Communication in 2011 warning that prescription proton pump inhibitors can cause hypomagnesemia, with serious cases involving abnormal heart rhythm, muscle spasm (tetany), and seizures.
pantoprazole + magnesium
Pantoprazole, like all proton pump inhibitors (PPIs), is associated with low magnesium (hypomagnesemia) after long-term use, likely by impairing active intestinal magnesium transport. The FDA included pantoprazole in its 2011 Drug Safety Communication on PPI-induced hypomagnesemia, which in severe cases can cause arrhythmia, tetany, and seizures.
furosemide + magnesium
Furosemide blocks the Na-K-2Cl cotransporter in the loop of Henle, which removes the electrical gradient that normally helps the kidney reabsorb magnesium. This can increase urinary magnesium loss, especially with high-dose or prolonged use. In most outpatients the kidney's downstream segments compensate, so clinically meaningful hypomagnesemia is less common with loop diuretics than with thiazides; the effect is more relevant during high-dose IV diuresis, critical illness, or poor intake.
dairy + digoxin
Dairy is a dietary source of calcium, and calcium status modestly influences how digoxin acts on the heart. The dietary-dairy effect is minor on its own; the more relevant scenario is large stacked calcium loads (dairy plus supplements plus calcium-containing antacids) or intravenous calcium in a hospital setting. Milk proteins may also slightly reduce digoxin absorption from oral doses, but the effect is small and usually not clinically meaningful.
alcohol + digoxin
There is no major direct chemical clash between alcohol and digoxin, but alcohol works indirectly to make digoxin less safe. Alcohol can trigger irregular heart rhythms (so-called holiday heart) and, along with diuretics, deplete potassium and magnesium. Because digoxin has a narrow safety margin, those electrolyte shifts make the heart more sensitive to it and raise the risk of digoxin toxicity. Heavy drinking can also worsen the heart failure digoxin is meant to treat.
energy drinks + beta-blockers
Energy drinks and beta-blockers exert opposing cardiovascular effects: beta-blockers slow heart rate and lower blood pressure, while the caffeine and stimulant load in energy drinks pushes the sympathetic system the other way. This can blunt the medication's effect and, in susceptible people, help provoke an arrhythmia.
licorice tea + digoxin
Licorice (Glycyrrhiza glabra) contains glycyrrhizin, which inhibits the renal enzyme 11-beta-hydroxysteroid dehydrogenase type 2 and produces mineralocorticoid-like potassium loss. The resulting hypokalemia increases the heart's sensitivity to digoxin, raising the risk of digoxin toxicity and dangerous arrhythmias.
alcohol + magnesium
Alcohol acts as an acute magnesium diuretic, increasing urinary magnesium excretion within hours of intake. Regular and heavy drinking can deplete body magnesium stores through renal wasting combined with reduced intestinal absorption and poor diet, and low magnesium is common in chronic alcohol-use disorder.
digoxin + licorice
Glycyrrhizin in licorice inhibits the kidney enzyme 11-beta-hydroxysteroid dehydrogenase type 2, producing a state of apparent mineralocorticoid excess that causes sodium retention and potassium loss. The resulting low potassium makes the heart more sensitive to digoxin and can trigger toxic arrhythmias even when serum digoxin levels look normal.