The short answer
Avoid adding glycyrrhizin-containing licorice to digoxin without medical review. Licorice-related potassium loss can increase digoxin toxicity; spacing does not establish protection.
What this answer covers
Glycyrrhizin-containing oral Gan cao/licorice root or stolon preparations with digoxin. Processed rhizome formulas and deglycyrrhizinated products need separate identity assessment.
- Supplement or preparation
- Radix et Rhizoma Glycyrrhizae
- Medication ingredient
- digoxin
The concern is potassium-related sensitivity
Licorice containing glycyrrhizin can cause potassium loss. Digoxin’s label says low potassium predisposes to toxicity. This does not require an increase in digoxin blood concentration, and it does not establish that digoxin itself increases potassium loss from licorice.
Regulatory guidance advises against co-use
The final licorice assessment advises against combining covered preparations with cardiac glycosides, the medicine group that includes digoxin. Ask the prescribing team for a plan if you already use both; do not stop the prescribed heart medicine to make room for an herbal product.
Confirm the preparation
Gan cao products vary in species, processing, plant part and other herbs. The assessment concerns specified root/stolon preparations with glycyrrhizin; a deglycyrrhizinated product is a different exposure. A few hours of separation has not been shown to prevent systemic potassium-related effects.
Know when to seek assessment
Contact your clinician about new nausea, loss of appetite, visual changes, marked weakness or an unusually slow or irregular pulse. These may have several causes, including digoxin toxicity. Blood results must be interpreted with symptoms, kidney function and electrolytes; do not adjust digoxin yourself.
Evidence and practical considerations
Side effects & toxicity
Glycyrrhizin-containing licorice may lower potassium and thereby increase susceptibility to digoxin toxicity.
- Exact scope
- Glycyrrhizin-containing oral Gan cao/licorice root or stolon preparations with digoxin. Processed rhizome formulas and deglycyrrhizinated products need separate identity assessment. with Exact digoxin RxCUI3407 IN, confirmed by current RxNorm. Oral125/250microgram tablets; oral absorption evidence is not transferred to IV digoxin. Digoxin is distinct from digitoxin.
- Medication form and route
- Oral
What remains uncertain
- Explicit cardiac-glycoside precaution plus low-potassium susceptibility; no exact product incidence, proven additive potassium loss or spacing solution.
Factors that may matter: Exact preparation and dose; Kidney function; Baseline electrolyte status; Other medicines.
Read the supporting source summaries
Source 1: Current prescribing information
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: Patients prescribed oral digoxin tablets.
Antacids and St.John’s wort can lower concentrations. Hypokalemia, hypomagnesemia and hypercalcemia predispose to toxicity; assess electrolytes/renal function. Some substances interfere with assays without proving increased drug exposure.
How this applies: Exact medication label. Exact digoxin RxCUI3407 IN, confirmed by current RxNorm. Oral125/250microgram tablets; oral absorption evidence is not transferred to IV digoxin. Digoxin is distinct from digitoxin.
No universal nutrient spacing or vitaminD replacement need. Clinical state, assay method and formulation must be considered.
Source 2: Final regulatory assessment
ema.europa.eu · Source check Sep 10, 2026
Population: Users of specified glycyrrhizin-containing licorice root/stolon preparations.
Mineralocorticoid effects can cause hypokalemia, fluid retention and hypertension. Co-use with diuretics or cardiac glycosides is not recommended.
How this applies: Constituent/preparation bridge to the current botanical entry; explicit medication-class precaution.
Defined root/stolon preparations, not every processed Gan cao rhizome/formula. Deglycyrrhizinated preparations differ; no exact combination incidence.
Source 3: Medication terminology
rxnav.nlm.nih.gov · Source check Sep 10, 2026
Population: Terminology.
digoxin is IN.
How this applies: Exact ingredient.
Not clinical evidence.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Article prepared | |
| Sources checked and article drafted. | |
| Research summary published |
Article revision: 0f8077c18328ce2e
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
Taking other supplements or medications?
Use the checker to explore your other combinations. Ask a pharmacist to review the exact products, amounts and medical conditions in your complete list.
Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.