PRECAUTIONS: Tell your doctor if you have a history of: liver or kidney disease, lung disease, thyroid problems, rheumatic fever. Food high in fiber may decrease the absorption of digoxin. Be sure to take digoxin a few hours before or after eating something high in fiber (such as bran). Difficulty breathing and swelling in your lower legs and ankles may be signs that your dose is too low. If normal activity causes shortness of breath or if you awaken frequently during the night due to shortness of breath, tell your doctor. Do not change your dose without consulting your doctor. Before having surgery, including dental surgery, tell the doctor that you take digoxin. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. Digoxin is excreted into breast milk. Though, to date, no problems have been noted in nursing infants, consult your doctor before breast-feeding.
DRUG INTERACTIONS: Tell your doctor of all prescription and nonprescription medication you may use, especially: amphotericin, diuretics ("water pills"), corticosteroids (e.g., prednisone), amiodarone, acarbose, neomycin, quinidine, cyclosporine, verapamil, quinine, thyroid medication, propafenone, sucralfate, erythromycin-like drugs, rifampin, bepridil, penicillamine, drugs used for cancer, tetracycline, dextrothyroxine, St John's wort. Cholestyramine, colestipol or psyllium (Metamucil) should be taken at least 2 hours after digoxin to prevent interference. If you are taking aminosalicylic acid (PAS), antacids, kaolin-pectin, milk of magnesia or sulfasalazine, take it as far apart as possible from digoxin. Do not start or stop any medicine without doctor or pharmacist approval.
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