Digoxin

Generic Name: digoxin (oral) (di JOX in)
Brand names: Digitek, Lanoxicaps, Lanoxin, Cardoxin

What is digoxin?

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Digoxin is derived from leaves of a digitalis plant. It helps make the heart beat stronger and with a more regular rhythm.

Digoxin is used to treat congestive heart failure. It is also used to treat atrial fibrillation, a heart rhythm disorder of the atria (the upper chambers of the heart that allow blood to flow into the heart).

Digoxin may also be used for purposes not listed here.

Important information about digoxin

You should not use this medication if you are allergic to digoxin, or if you have ventricular fibrillation (a heart rhythm disorder of the ventricles, or lower chambers of the heart that allow blood to flow out of the heart).

Before using digoxin, tell your doctor if you have certain heart conditions, especially "AV block" (unless you have a pacemaker), or a recent history of heart attack. Also tell your doctor if you have kidney disease, a thyroid disorder, an electrolyte imbalance (such as low levels of calcium, potassium, or magnesium in your blood), or if you are malnourished or have recently been sick with vomiting or diarrhea.

Keep taking digoxin as directed, even if you feel well. Get your prescription refilled before you run out of medicine completely.

Do not stop taking digoxin without first talking to your doctor. Stopping suddenly may make your condition worse.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Digoxin overdose can occur more easily if you are dehydrated.

There are many other medicines that can interact with digoxin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Before taking digoxin

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before using digoxin, tell your doctor if you have:

certain heart conditions, especially "AV block" (unless you have a pacemaker);
a recent history of heart attack;
kidney disease;
a thyroid disorder;
an electrolyte imbalance (such as low levels of calcium, potassium, or magnesium in your blood); or
if you are malnourished or have recently been sick with vomiting or diarrhea.

FDA pregnancy category C. Digoxin may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Digoxin can pass into breast milk and may harm a nursing baby. Do not use digoxin without telling your doctor if you are breast-feeding a baby. Older adults may be more likely to have side effects from digoxin.

How should I take digoxin?

Take digoxin exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Take digoxin with a full glass of water.

Try to take the medication at the same time every day.

Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

To be sure digoxin is not causing harmful effects, your blood may need to be tested on a regular basis. Your kidney function may also need to be tested. Do not miss any scheduled appointments.

Keep taking digoxin as directed, even if you feel well. Get your prescription refilled before you run out of medicine completely.

Do not stop taking digoxin without first talking to your doctor. Stopping suddenly may make your condition worse. Store digoxin at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If your next dose is less than 12 hours away, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much digoxin.

Overdose symptoms may include nausea, vomiting, diarrhea, loss of appetite, blurred vision, seeing halos around lights or objects, severe skin rash, fast/slow or uneven heartbeats, and feeling like you might pass out.

What should I avoid while taking digoxin?

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Digoxin overdose can occur more easily if you are dehydrated.

Digoxin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

fast, slow, or uneven heart rate;
bloody or black, tarry stools;
blurred vision, yellowed vision; or
confusion, hallucinations, unusual thoughts or behavior.

Less serious digoxin side effects may include:

mild nausea, vomiting, diarrhea;
feeling weak or dizzy;
headache;
enlarged breasts in men; or
mild skin rash.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect digoxin?

Many drugs can interact with digoxin. Below is just a partial list. Tell your doctor if you are using:

an antacid, or Kaopectate;
alprazolam (Xanax);
cancer medications;
clonidine (Catapres);
supplements or medications that contain calcium;
a diuretic (water pill), such as spironolactone (Aldactone, Aldactazide);
amphotericin B (Fungizone, AmBisome, Abelcet);
cholestyramine (Questran, Prevalite);
epinephrine (EpiPen);
guanabenz (Wytensin) or guanfacine (Tenex);
indomethacin (Indocin);
isoproterenol (Isuprel);
itraconazole (Sporanox);
levothyroxine (Synthroid, Levothroid, and others);
methyldopa (Aldomet);
metoclopramide (Reglan);
neomycin (Mycifradin, Neo-Fradin, Neo-Tab);
rifampin (Rifadin, Rifater, Rifamate);
sulfasalazine (Azulfidine); or
an antibiotic such as erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), clarithromycin (Biaxin), or tetracycline (Brodspec, Panmycin, Sumycin, Tetracap);
a beta-blocker such as carvedilol (Coreg), metoprolol (Lopressor, Toprol), and others;
a calcium channel blocker such as amlodipine (Norvasc), diltiazem (Tiazac, Cartia, Cardizem), felodipine (Plendil), nisoldipine (Sular), verapamil (Calan, Covera, Isoptin, Verelan), and others;
decongestant cold or allergy medicine, or nasal sprays such as Afrin, Duramist, Neo-Synephrine, Tysine Nasal, and others;
a heart rhythm medication such as amiodarone (Cordarone, Pacerone), propafenone (Rythmol), or quinidine (Quinaglute, Quinidex, Quin-Release); or
steroids such as prednisone, fluticasone (Advair), mometasone (Asmanex, Nasonex), dexamethasone (Decadron, Hexadrol) and others.

This list is not complete and there are many other medicines that can interact with digoxin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Where can I get more information?

Your pharmacist can provide more information about digoxin.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.