digoxin (Lanoxin, Lanoxin Pediatric)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical and Pharmacy Editor: Jerry R. Balentine, DO, FACEP
    Jerry R. Balentine, DO, FACEP

    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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What is digoxin, and how does it work (mechanism of action)?

  • Digoxin increases the strength and efficiency of heart contractions, and is useful in the treatment of heart failure and control the rate and rhythm of the heart. It is extracted from the leaves of a plant called digitalis lanata. Digoxin increases the force of contraction of the muscle of the heart by inhibiting the activity of an enzyme (ATPase) that controls movement of calcium, sodium, and potassium into heart muscle. Calcium controls the force of contraction. Inhibiting ATPase increases calcium in heart muscle and therefore increases the force of heart contractions. Digoxin also slows electrical conduction between the atria and the ventricles of the heart and is useful in treating abnormally rapid atrial rhythms such as atrial fibrillation, atrial flutter, and atrial tachycardia. (Abnormally rapid atrial rhythms can be caused by heart attacks, excessive thyroid hormones, alcoholism, infections, and many other conditions.) During rapid atrial rhythms, electrical signals from the atria cause rapid contractions of the ventricles. Rapid ventricular contractions are inefficient in pumping blood containing oxygen and nutrients to the body, causing symptoms of weakness, shortness of breath, dizziness, and even chest pain. Digoxin alleviates these symptoms by blocking the electrical conduction between the atria and ventricles, thus slowing ventricular contractions.
  • The FDA approved digoxin in 1975.

What brand names are available for digoxin?

Lanoxin, Lanoxin Pediatric

Is digoxin available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for digoxin?

Yes

What are the uses for digoxin?

What are the side effects of digoxin?

Common side effects include

Many digoxin side effects are dose dependent and happen when blood levels are over the narrow therapeutic range. Therefore, digoxin side effects can be avoided by keeping blood levels within the therapeutic level. Serious side effects associated with digoxin include

  • heart block,
  • rapid heartbeat, and
  • slow heart rate.

Digoxin has also been associated with visual disturbance (blurred or yellow vision), abdominal pain, and breast enlargement. Patients with low blood potassium levels can develop digoxin toxicity even when digoxin levels are not considered elevated. Similarly, high calcium and low magnesium blood levels can increase digoxin toxicity and produce serious disturbances in heart rhythm.

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What is the dosage for digoxin?

  • Digoxin may be taken with or without food.
  • Digoxin primarily is eliminated by the kidneys; therefore, the dose of digoxin should be reduced in patients with kidney dysfunction.
  • Digoxin blood levels are used for adjusting doses in order to avoid toxicity.
  • The usual starting dose is 0.0625-0.25 mg daily depending on age and kidney function.
  • The dose may be increased every two weeks to achieve the desired response.
  • The usual maintenance dose is 0.125 to 0.5 mg per day.

Which drugs or supplements interact with digoxin?

:

Is digoxin safe to take if I'm pregnant or breastfeeding?

  • There are no adequate studies in pregnant women.
  • Digoxin in secreted in breast milk at concentrations similar to concentrations in the mothers blood. However, the total amount of digoxin that will be absorbed from breast milk by the infant may not be enough to cause effects. Caution should be exercised by nursing mothers who are taking digoxin.

What else should I know about digoxin?

What preparations of digoxin are available?

  • Tablets: 0.0625, 0.125, 0.1875, and 0.25 mg; Elixir: 0.05 mg/ml.
  • Injectable Solution: 0.1 and 0.25 mg/ml.

How should I keep digoxin stored?

Digoxin should be stored at room temperature, 15 C and 30 C) (59 F and 86 F) and protected from light.

REFERENCE: FDA Prescribing Information

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Summary

Digoxin (Lanoxin, Lanoxin Pediatric) is used in the treatment of congestive heart failure and abnormally rapid atrial rhythms (atrial fibrillation, atrial flutter, atrial tachycardia). Drug interactions include calcium channel blockers, beta blockers, diuretics, and others. Common side effects include

Drug interactions, dosage, and pregnancy and breastfeeding information are provided.

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See more info: digoxin on RxList
Reviewed on 8/8/2016
References
REFERENCE: FDA Prescribing Information

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