Table 4.
Herbal Products That May Interfere With Digoxin Level and Assays
Herb | Extent of Interference | Comments |
---|---|---|
Chan su | High | Active components (eg, bufalin) cross-react with digoxin assay; Monitoring free digoxin eliminates interference |
Danshen | Moderate | Falsely increases (FPIA) or falsely decreases low levels (MEIA) of digoxin; Monitoring free digoxin eliminates interference |
Asian ginseng | Moderate | Falsely increases elevated (FPIA) or falsely decreases low (MEIA) digoxin level; Monitoring free digoxin does not eliminate interference |
Siberian ginseng | Moderate | Falsely increases elevated (FPIA) or falsely decreases low (MEIA) digoxin; Monitoring free digoxin does not eliminate interference |
Uzara root (diuretic) | NA | Increases effect with digoxin; Interferes with digoxin assay |
Abbreviations: FPIA, fluorescence polarization immunoassay; MEIA, microparticle enzyme immunoassay; NA, not available.
Adapted from Dasgupta A. Review of abnormal laboratory test results and toxic effects due to use of herbal medicines. Am J Clin Pathol. 2003 Jul;120(1):127–37. Used with permission.