Digoxin

Heart failure and atrial fibrillation, that is, a disorder of the heart rhythm affecting the upper chamber of the organ, can be effectively treated with the help of Digoxin. The drug is extracted from the leaves of the digitalis plant. Digoxin strengthens heartbeat and helps regulate the rhythm of the heart.

The drug is not suitable for patients who suffer from ventricular fibrillation, that is, a disorder of the heart rhythm affecting the ventricles. Before one starts a course of this medicine, it is essential that they discuss their medical history with their health care provider.

To ensure that the drug is perfectly safe for consumption, inform your doctor about any allergies or current health problems you are suffering from. Here are a list of health conditions you should inform your doctor about before your begin taking Digoxin -

• AB blockage or sick sinus syndrome
• heart attack in the recent past
• problems with heart beat
• kidney, thyroid or liver problems
• malnourishment
• electrolyte imbalance

Also inform your medical professional if you are pregnant or are breast feeding. The drug is not known to have any negative impact of an unborn child or a new born infant, but it is best to discuss the possibilities of taking the drug with the doctor in this case.

A few side effects that you may develop when taking Digoxin are anxiety, depression, vomiting, rashes, diarrhea and a sense of agitation. You can discuss with you doctor different ways by which you can stop the onset of such symptoms. If any of these side effects continue for a long time or tend to worsen it is best that you seek medical help as soon as possible.

Take as directed; do not discontinue without consulting prescriber. Maintain adequate dietary intake of potassium (do not increase without consulting prescriber). Adequate dietary potassium will reduce risk of digoxin toxicity.

Take pulse at the same time each day; follow prescriber instructions for holding medication if pulse is below 50. Notify prescriber of acute changes in pulse. Report loss of appetite, nausea, vomiting, persistent diarrhea, swelling of extremities, palpitations, "yellowing" or blurred vision, mental confusion or depression, or unusual fatigue.

Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Cardiologist before using this medicine.

• Heart Failure

• Arrhythmia

Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Cardiologist before using this medicine.

• Allergy

• Ventricular Fibrillation

Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Cardiologist before using this medicine.

• Nausea

• Vomiting

• Diarrhoea

• Skin Rash

• Slow Heart Rate

• Visual Disturbances

• Dizziness

• Urticaria

• Pruritus

• Confusion

• Weakness

Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Cardiologist before using this medicine.

• Is It safe with alcohol?

  Interaction with alcohol is unknown. Please consult your doctor.

• Are there any pregnancy warnings?

  Digoxin may be unsafe to use during pregnancy.
  Animal studies have shown adverse effects on the foetus, however, there are limited human studies. The benefits from use in pregnant women may be acceptable despite the risk. Please consult your doctor.

• Are there any breast-feeding warnings?

  Digoxin is safe to use during lactation. \nHuman studies have shown that either the drug does not pass into the breastmilk in significant amount or is not expected to cause toxicity to the baby.

• Is it safe to drive while on this medicine?

  Digoxin may make you feel dizzy, drowsy or affect your vision. Do not drive until your vision is clear.
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• Does this affect kidney function?

  Digoxin should be used with caution in patients with kidney disease. Dose adjustment of Digoxin may be needed. Please consult your doctor.
  Regular monitoring of kidney function tests, potassium, magnesium and calcium levels is advisable while you are taking this medicine.

• Does this affect liver function?

  Digoxin is probably safe to use in patients with liver disease. Limited data available suggests that dose adjustment of Digoxin may not be needed in these patients. Please consult your doctor.

Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Cardiologist before using this medicine.

• Are there any missed dose instructions?

  If you miss a dose of Digoxin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.\n

• Are there any overdose instructions?

  Seek emergency medical treatment or contact the doctor in case of an overdose.

Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Cardiologist before using this medicine.

• India

• United States

• Japan

Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Cardiologist before using this medicine.

This medication belongs to the class of a cardiac glycoside that works by inhibiting the sodium-potassium adenosine triphosphatase (Na-K ATPase) pump. This increases the calcium concentration in the blood which in turn improves contractility of the heart by activating contractile proteins like myosin and actin.

Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Cardiologist before using this medicine.

Whenever you take more than one medicine, or mix it with certain foods or beverages, you"re at risk of a drug interaction.

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• Interaction with Medicine

  • Amiloride may reduce the inotropic response to Digoxin.
  • Cholestyramine, colestipol, kaolin-pectin may reduce Digoxin absorption. Separate administration.
  • Levothyroxine (and other thyroid supplements) may decrease Digoxin blood levels.
  • Metoclopramide may reduce the absorption of Digoxin.
  • Penicillamine has been associated with reductions in Digoxin blood levels
  • Amiodarone reduces renal and nonrenal clearance of Digoxin and may have additive effects on heart rate. Reduce Digoxin dose by 50% with start of amiodarone.
  • Benzodiazepines (alprazolam, diazepam) have been associated with isolated reports of Digoxin toxicity.
  • Beta-blocking agents (propranolol) may have additive effects on heart rate.
  • Calcium preparations: Rare cases of acute Digoxin toxicity have been associated with parenteral calcium (bolus) administration.
  • Carvedilol may increase Digoxin blood levels in addition to potentiating its effects on heart rate.
  • Cyclosporine may increase digoxin levels, possibly due to reduced renal clearance.
  • Erythromycin, clarithromycin, and tetracyclines may increase digoxin (not capsule form) blood levels in a subset of patients.
  • Indomethacin has been associated with isolated reports of increased digoxin blood levels/toxicity.
  • Itraconazole may increase digoxin blood levels in some patients; monitor.
  • Moricizine may increase the toxicity of Digoxin(mechanism undefined).
  • Propafenone increases digoxin blood levels. Effects are highly variable; monitor closely.
  • Propylthiouracil (and methimazole) may increase digoxin blood levels by reducing thyroid hormone.
  • Quinidine increases digoxin blood levels substantially. Effect is variable (33% to 50%). Monitor digoxin blood levels/effect closely. Reduce Digoxin dose by 50% with start of quinidine. Other related agents (hydroxychloroquine, quinine) should be used with caution.
  • Spironolactone may interfere with some digoxin assays, but may also increase blood levels directly. However, spironolactone may attenuate the inotropic effect of Digoxin. Monitor effects of digoxin closely.
  • Succinylcholine administration to patients on Digoxin has been associated with an increased risk of arrhythmias.
  • Verapamil diltiazem, bepridil, and nitrendipine increased serum digoxin concentrations. Other calcium channel blocking agents do not appear to share this effect. Reduce Digoxin's dose with the start of verapamil.
  • Drugs which cause hypokalemia (thiazide and loop diuretics, amphotericin B): Hypokalemia may potentiate Digoxin toxicity.
  • These medications have been associated with reduced digoxin blood levels which appear to be of limited clinical significance: Aminoglutethimide, aminosalicylic acid, aluminum-containing antacids, sucralfate, sulfasalazine, neomycin, ticlopidine.
  • These medications have been associated with increased digoxin blood levels which appear to be of limited clinical significance: Famciclovir, flecainide, ibuprofen, fluoxetine, nefazodone, cimetidine, famotidine, ranitidine, omeprazole, trimethoprim.

• Interaction with Disease

  • Withdrawal in CHF patients may lead to recurrence of CHF symptoms.
  • Some arrhythmias that Digoxin is used to treat may be exacerbated in digoxin toxicity.
  • Sinus nodal disease may be worsened.
  • Adjust doses in renal impairment and when verapamil, quinidine or amiodarone are added to a patient on Digoxin.
  • Correct hypokalemia and hypomagnesemia before initiating therapy.
  • Calcium, especially when administered rapidly I.V., can produce serious arrhythmias. Atrial arrhythmias associated with hypermetabolic states are very difficult to treat.
  • Rate control in atrial fibrillation may be better in a sedentary patient than an active one.
  • Use with caution in acute MI (within 6 months). Serum concentration monitoring should be done before the next dose (patient can hold AM dose for blood test) for an accurate assessment.
  • Reduce or hold dose 1-2 days before elective electrical cardioversion.

• Interaction with Food

  Meals containing increased fiber (bran) or foods high in pectin, may decrease oral absorption of digoxin; avoid natural licorice (causes sodium and water retention and increases potassium loss); maintain adequate amounts of potassium in diet to decrease risk of hypokalemia (hypokalemia may increase risk of digoxin toxicity).