Digoxin vs. digitalis

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

Digoxin vs. digitalis: What's the difference?

What are digoxin and digitalis?

Digoxin is a cardiac glycoside used for treating adults with mild to moderate congestive heart failure and for treating abnormally rapid atrial rhythms (atrial fibrillation, atrial flutter, atrial tachycardia). It also is used for increasing myocardial contractility in pediatric patients with heart failure. 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 the heart muscle. Calcium controls the force of contraction. Inhibiting ATPase increases calcium in the 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.

Digitalis is a cardiac glycoside used to treat certain heart conditions such as congestive heart failure (CHF) and heart rhythm problems (atrial arrhythmias). Digitalis works directly on the heart muscle to strengthen and regulate the heartbeat.

What are the side effects of digoxin and digitalis?

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:

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.

Digitalis

As your body adjusts to the medication, the following side effects may occur:

Inform your doctor if you develop any of these side effects:

  • confusion,
  • visual disturbances (blurred vision or yellow/green halos around objects),
  • fast/slow/irregular heartbeat,
  • skin rash,
  • breast enlargement,
  • severe stomach upset.

If you notice any other side effects, contact your doctor or pharmacist.

What is the dosage for digoxin vs. digitalis?

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.

Digitalis

  • Take this medication exactly as directed by your doctor.
  • Try to take it at the same time each day.
  • To avoid stomach upset, this medication may be taken with food or milk.
  • Consult with your doctor before you stop taking this medication.

SLIDESHOW

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What drugs interact with digoxin and digitalis?

Digoxin

Digitalis

Provide your doctor with a list of all medications you use -- including over-the-counter and prescription drugs, and herbal supplements -- especially the following:

After taking digitalis, wait at least 2 hours before taking the following:

These medications should be taken as far apart from digitalis as possible:

  • aminosalicylic acid (PAS),
  • antacids,
  • kaolin-pectin,
  • Milk of Magnesia, and
  • sulfasalazine.

Are digoxin and digitalis safe to use while pregnant or breastfeeding?

Digoxin

  • There are no adequate studies in pregnant women.
  • Digoxin is secreted in breast milk at concentrations similar to concentrations in the mother's blood. However, the total amount of digoxin that will be absorbed from breast milk by the infant may not be enough to cause effects. Nursing mothers should exercise caution when taking digoxin.

Digitalis

  • Pregnant women should only use this medication if clearly needed and discuss the risks and benefits with their doctors.
  • Digitalis is excreted into breast milk. Women using this medication should consult their doctors before breastfeeding.

Summary

Digoxin and digitalis are cardiac glycosides that are derived from the same plant, the foxglove, used to treat adults with mild to moderate congestive heart failure and to treat abnormally rapid atrial rhythms (atrial fibrillation, atrial flutter, atrial tachycardia). Digoxin also is used for increasing myocardial contractility in pediatric patients with heart failure.

Treatment & Diagnosis

Medications & Supplements

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Medically Reviewed on 7/31/2019
References
FDA Prescribing Information
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