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Digoxin

Generic Name: Digoxin (oral or injection) [ di-JOX-in]
The Brand Names are Digitek, Digox, Lanoxin, Lanoxicaps, and Cardoxin.
Drug Classes: Group V antiarrhythmics, inotropic agents

What is Digoxin?

Digoxin Digoxin is taken from the leaves of the digitalis plant. Digoxin assists in making the heartbeat with a more powerful and consistent rhythm.Digoxin is used to treat heart conditions.

Digoxin is also utilized for treating atrial fibrillation, a heart rhythm disorder that affects the atria (the higher chambers in the heart that allow blood to enter the coronary artery).

Warnings

It is not recommended to use digoxin when you suffer from heart fibrillation (a heart rhythm disorder affecting the ventricles or the lower chambers of the heart that permit the flow of blood out of the heart).

Before you Take this Drug

It is not recommended to take digoxin in the event that you are sensitive to it or if you suffer from heart fibrillation (a heart rhythm disorder that affects the ventricles or lower heart chambers that permit blood to flow out of the heart).

To ensure that digoxin is suitable for you, inform your doctor if you have previously had:

  • A serious heart issue that is serious, such as "sick sinus syndrome" or "AV block" (unless you are a patient with an implanted pacemaker);
  • A heart attack;
  • Irregular heartbeats, which have caused your heart to slur;
  • Wolff-Parkinson-White Syndrome (sudden fast heartbeats);
  • Kidney disease;
  • An electrolyte imbalance (such as low amounts of potassium, calcium, and magnesium levels in the blood);
  • An thyroid disorder;
  • If you've recently suffered from diarrhea and/or vomiting,

Consult your physician if you are expecting. It's not clear if digoxin can harm an unborn baby. However, heart failure or atrial fibrillation during pregnancy could result in complications such as premature birth, an infant with a low birth weight, or even a death risk for both baby and mother. The benefits of treating heart issues with digoxin could outweigh any dangers for the baby.It is not always safe to breastfeed while taking digoxin. Talk to your doctor about any risks.

How to Take Digoxin?

Use digoxin as directed by your physician. Follow all instructions on the prescription label and go through all medication guides and instructions on the label.Make sure to take your oral digoxin at the exact time each day.

Take care when measuring liquid medicines. Make use of the dosing syringe supplied or a dosage-measuring device (not the kitchen spoon).

You should take digoxin every day, even if you are feeling well or don't have any symptoms. Refill your prescription prior to the expiration date of the medication.

Digoxin injections are delivered as a shot in the muscles or as an infusion into the vein. The healthcare professional can give you the injection if you're not in a position to take the medicine by mouth.Your heart rate and blood pressure must be checked every day.It is possible that you will need frequent blood tests. The kidney's function may be examined.

Do not discontinue taking this medication suddenly. The abrupt stop can increase the severity of your illness.Place it in a cool, dry place free of heat and moisture.

Details on Dosage

Usual Adult Dose of Digoxin for Congestive Heart Failure:

Rapid Digitalization Using a Loading Dose:
The body stores of digoxin that peak at 8–12 mg/kg usually have a therapeutic effect and the lowest risk of toxicity for the majority of patients with sinus rhythm.
The loading dose must be administered in multiple parts in a half-dose, with the first dose being administered as the initial dose. Additional parts of the total dose can be administered at 6- to 8-hour intervals. A careful evaluation of the patient's clinical reaction should be taken into consideration prior to every dose. If the patient's reaction requires an adjustment from the dose that is calculated for loading digoxin, the calculation of the maintenance dosage must be based on the dose actually administered.
Tablets:
Initial dose: 500–750 mg typically produces a discernable effect within 0.5–2 hours, with the maximum effect occurring within 2–6 hours. Additional doses of 125–375 mg may be administered at 6- to 8-hour intervals until evidence of an effective effect is observed. The typical dosage of tablets that a person of 70kg needs to reach 8 to 12 mcg/kg of maximum body stores is 750–1500 mg.
Capsules:
Initial: 400–600 mg of digoxin capsules usually result in a visible effect within 0.5–2 hours, with an effect that is maximal within 2–6 hours. Additional doses of between 100 and 300 mg can be administered in 6- to 8-hour intervals until evidence of a sufficient result is found. The amount of capsules one needs for a 70-kg person to reach 8–12 mcg/kg of peak body stores is between 600 and 1000 mcg.
Injection:
Initial: 400–600 mg of digoxin administered intravenously will generally show a visible effect within 5–30 minutes, with an effect that lasts for 1–4 hours. Additional doses of 100–300 mg can be administered at 6- and 8-hour intervals until evidence of a sufficient effect is observed. The typical dose of digoxin injection required by a person weighing 70kg to reach 8–12 mcg/kg of body stores at peak is 600–1000 mcg. Injectable routes are often utilized to speed up digitalization, followed by conversion to digoxin tablets or capsules to maintain therapy.

Maintenance Dose:
The dosages of digoxin tablets that were tested in controlled trials with patients suffering from heart failure have varied from 125 to 500 mg daily. These studies have shown that the dosage has generally been adjusted depending on the patient's weight, age, lean body mass, and kidney function. The treatment is usually started at a dose of 200 mg daily for patients who are younger than 70 years old and have good kidney function.

Usual Adult Dose for Atrial Fibrillation:

The body stores more than the 8–12 milligrams/kg that are required by most people suffering from heart failure, and sinus rhythms that are normal are used to control the ventricular rate of patients suffering from atrial fibrillation. Doses prescribed for the treatment of chronic fibrillation must be adjusted to the lowest dosage that allows for control of ventricular rate without causing unwanted side effects.

Usual Pediatric Dose for Atrial Fibrillation:

Do not administer the full digitalizing dose all at once. Give loading doses in multiple portions, giving approximately half of the total dose in the first dose. Offer additional portions of the dose in intervals of 6 to 8 hours (oral) or 4 to 8 hours (parenteral). Daily dosing split is recommended for infants as well as young children younger than 10 years old.
Parenteral administration should be utilized only in situations where immediate digitalization is critical or when the drug can't be administered orally. The intravenous route is preferred over intramuscular injections as it may result in intense discomfort at the injection site. If it is required to administer the drug via intramuscular route, it is recommended to inject it deep into the muscle, followed by a massage. A maximum of 500 mcg can be injected into only one area.
The doses calculated should be based on lean body weight.
Premature:
Digitalizing (loading) dosage: oral elixir, 20–30 mcg/kg. Intravenous: 15–25 mg/kg
Maintenance dosage is ingestion: 5 to 7.5 mg/kg; intravenous: 4 to 6 mg/kg.
Full Term:
Digitalizing (loading) dosage: oral elixir, 25 to 35 mg/kg; intravenous, 20 to 30 mg/kg
Maintenance dosage Dosage: inhalation 6 to 10 mg/kg and intravenous 5 to 8 mg/kg
1-24 months:
Digitalizing (Loading) dosage: oral liquid: 35 to 60 mg/kg; intravenous injection: 30 to 50 mcg/kg
Maintenance dosage 10 to 15 mg/kg orally in the form of intranasal 7.5 to 12 mg/kg
3 to 5 year olds:
Digitalizing (loading) dosage: oral elixir: 30 to 40 mg/kg; intravenous: 25-35 mg/kg
Maintenance dose orally: 7.5 to 10 mg/kg; intracoronal: 6 to 9 mg/kg
6-10 years:
Digitalizing (loading) dosage: oral elixir: 20 to 35 mg/kg; intravenous: 15 to mg/kg
Maintenance dosage Dosage: oral 5 to 10 mg/kg; intravenous 4–8 mcg/kg
11 years old and over:
Digitalizing (loading) dosage: oral elixir: 10 to mg/kg; intravenous injection: 8 to 12 mg/kg
Maintenance dosage Dosage for maintenance: orally, 2.5 to 5 mg/kg; intravenous, 2 to 3 mg/kg.

What Happens If I Miss a Dose?

You should take the medication as soon as you can. However, do not miss any missed dose if the scheduled dose comes due within just 12 or fewer hours. Don't take two doses at the same time.

What Happens If I Overdose?

Get medical attention immediately or contact the Poison Help line at 1-800-222-1222. A dose of digoxin that is too high can cause death.

Some symptoms of an overdose include nausea, loss of appetite, vomiting, and tiredness.

What Should be Avoided?

Beware of becoming dehydrated or overheated when exercising, during the heat, or simply due to not drinking enough fluids. Overdoses of digoxin can happen more frequently if you're dehydrated.

Side effects of Digoxin

See a doctor immediately. Get medical attention immediately if you show symptoms that you are experiencing an allergic reaction due to digoxin, such as hives, breathing problems, and swelling of your lips, face, and tongue.

See your doctor right away. If you suffer from:

  • Nausea, vomiting, diarrhea, and stomach pain;
  • Either a slow, fast, or irregular heart rate;
  • A lightheaded sensation, similar to feeling like you're about to pass out.
  • Bloody or black stools, tarry stool;
  • Hallucinations, confusion, weakening abnormal thoughts or behaviors;
  • Breast tenderness or swelling;
  • Fuzzy vision, yellowed eyes,
  • (in infants or children) stomach pain (in infants or children), losing weight, and growth delays (in children or babies) stomach pain, weight loss, and changes in behavior

Risky side effects are more frequent in older patients or those who are debilitated or have a debilitating condition.

Common side effects of digoxin include:

  • Nausea, diarrhea;
  • Being dizzy or weak;
  • Headache or weakness, anxiety, depression,

Rash. It's not a comprehensive listing of all negative consequences. There are other possibilities for this to happen. Talk to your physician for medical advice about adverse effects. If you experience any side negative effects to the FDA by calling 1-800-FDA-1088.

Interactions with Other Drugs

It is not recommended to take specific medicines at the same time. Certain drugs may affect the blood levels of other medications that you take, which can cause more side effects or make the medication less effective.

A variety of drugs may be incompatible with digoxin. It includes over-the-counter and prescription vitamin supplements, medications, as well as herbal supplements. The interactions of all drugs are not mentioned here. Inform your doctor of your current medications as well as any medications you begin or stop taking.

DRUG STATUS

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Prescription only

Pregnancy & Lactation

CSA Schedule*

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