Digoxin
Digoxin is used to treat heart failure and atrial fibrillation. It is available as Lanoxin and is commonly prescribed in the cardiovascular category.
About Digoxin
Digoxin is a cardiac glycoside (na⁺/k⁺-atpase inhibitor) also known by the brand name Lanoxin. It is primarily used to digoxin is prescribed to treat: • Heart failure and atrial fibrillation • Various related conditions in the cardiovascular category • Associated symptoms and complications It is an important medication that helps manage these conditions effectively. Digoxin is available in oral tablet (62.5 mcg, 125 mcg, 187.5 mcg, 250 mcg), oral solution (50 mcg/ml pediatric), and iv injection (100 mcg/ml, 250 mcg/ml) form. Healthcare providers commonly prescribe Digoxin for conditions including Atrial Fibrillation, Attention Deficit Hyperactivity Disorder (ADHD), Lupus Anticoagulant, and Vertigo.
Digoxin at a Glance
- Brand names
- Lanoxin
- Drug class
- Cardiac Glycoside (Na⁺/K⁺-ATPase Inhibitor)
- Pregnancy category
- FDA Category Category C — Animal reproduction studies are inadequate, and digoxin readily crosses the placenta. It has been used during pregnancy to treat fetal supraventricular tachycardia and maternal arrhythmias when benefits outweigh risks. Maternal serum levels should be monitored carefully because of altered pharmacokinetics during pregnancy.
- Available forms
- Oral tablet (62.5 mcg, 125 mcg, 187.5 mcg, 250 mcg), Oral solution (50 mcg/mL pediatric), IV injection (100 mcg/mL, 250 mcg/mL)
- Therapeutic categories
- Cardiovascular, Heart Failure, Arrhythmia
- Conditions treated
- 4 related conditions on this site
What Digoxin Is Used For
Digoxin is prescribed to treat:
• Heart failure and atrial fibrillation • Various related conditions in the cardiovascular category • Associated symptoms and complications
It is an important medication that helps manage these conditions effectively.
Dosage Quick Reference
These are general dosage guidelines for Digoxin. Your doctor will determine the appropriate dose for your specific situation.
| Condition | Starting Dose | Maintenance Dose |
|---|---|---|
| Heart failure (chronic, normal renal function) | 125–250 mcg orally once daily | 125–250 mcg once daily; target serum level 0.5–0.9 ng/mL |
| Heart failure (older adults or CrCl 30–50 mL/min) | 62.5–125 mcg orally once daily | 62.5–125 mcg once daily with serum level monitoring |
| Atrial fibrillation rate control (chronic) | 250 mcg orally once daily | 125–250 mcg once daily; titrate to ventricular rate < 110 bpm at rest |
| Atrial fibrillation (acute IV loading) | 0.25 mg IV every 2 hours, max 1.5 mg in 24 hr | Transition to oral maintenance |
Side Effects
Common side effects may include:
• Nausea or stomach upset • Headache • Dizziness or lightheadedness • Fatigue or tiredness • Mild rash or itching
Serious side effects (seek immediate medical attention):
• Severe allergic reactions (rash, hives, swelling, difficulty breathing) • Unusual bleeding or bruising • Severe stomach pain • Signs of liver problems (yellowing of skin/eyes, dark urine) • Chest pain or irregular heartbeat • Severe dizziness or fainting • Signs of serious adverse effects
See also: Drug Interactions ↓
Drug Interactions
Digoxin has a narrow therapeutic index, and many common medications can raise its serum concentration into the toxic range.
- Amiodarone, dronedarone, verapamil, quinidine, propafenone: All inhibit P-glycoprotein-mediated digoxin clearance, raising digoxin levels by 50% to 100%. Reduce digoxin dose by approximately 50% when these are co-administered and recheck a serum digoxin level within one week.
- Loop and thiazide diuretics (e.g., furosemide, hydrochlorothiazide): Cause hypokalemia and hypomagnesemia, which sensitize the myocardium to digoxin and increase the risk of arrhythmias even at therapeutic digoxin concentrations. Monitor and replete electrolytes proactively.
- Macrolide antibiotics (e.g., clarithromycin, erythromycin): Eliminate gut flora that metabolize digoxin and inhibit P-glycoprotein, sharply increasing absorption and levels. Monitor digoxin levels and consider temporary dose reduction during the antibiotic course.
- Spironolactone and eplerenone: Can raise digoxin concentrations and interfere with some serum digoxin assays, producing falsely elevated readings. Use clinical signs alongside laboratory levels.
- Cholestyramine, colestipol, kaolin-pectin, antacids: Bind digoxin in the gut and reduce absorption. Separate administration by at least 2 hours.
- Beta-blockers and non-dihydropyridine calcium channel blockers: Combined AV nodal blockade can produce excessive bradycardia or high-degree AV block. Monitor heart rate and ECG.
See also: Questions to Ask Your Doctor ↓
Key Considerations
Known drug interactions
Digoxin has documented interactions with other medications, supplements, and certain foods. Review the Drug Interactions section below and tell your healthcare provider about every medication you take, including over-the-counter products. Jump to section →
Multiple forms available
Digoxin comes in more than one form (Oral tablet (62.5 mcg, 125 mcg, 187.5 mcg, 250 mcg), Oral solution (50 mcg/mL pediatric), IV injection (100 mcg/mL, 250 mcg/mL)). The right form for you depends on your condition, ease of use, and your provider's recommendation.
Additional Information
What is Digoxin?
Digoxin (generic name: Digoxin) is a medication primarily used to treat heart failure and atrial fibrillation. It is marketed under the brand name(s) Lanoxin and belongs to the Cardiovascular category of medications.
How Does Digoxin Work?
Digoxin works through several mechanisms to provide therapeutic benefits:
- Acts on specific receptors or pathways in the body
- Modulates biological processes related to the treated condition
- Provides symptom relief and improves quality of life
- Helps manage the underlying condition effectively
- Works best when combined with appropriate lifestyle modifications
The medication is designed to target the specific pathways involved in heart failure and atrial fibrillation, making it an effective treatment option.
Common Uses
Primary Indications
Digoxin is commonly prescribed for:
- Heart failure and atrial fibrillation: The main indication for this medication
- Related Conditions: Associated symptoms and complications
- Prevention: May help prevent progression of certain conditions
- Symptom Management: Reduces discomfort and improves daily function
Additional Uses
In some cases, Digoxin may also be prescribed for:
- Off-label uses as determined by your healthcare provider
- Combination therapy with other medications
- Long-term management of chronic conditions
- Short-term treatment of acute symptoms
Dosage and Administration
Digoxin dosing varies based on the specific condition being treated and individual patient factors.
Typical Dosing:
- Starting dose is typically determined by your healthcare provider
- May be adjusted based on response and tolerability
- Can be taken with or without food (follow specific instructions)
- Usually taken once or twice daily
Administration Tips:
- Take at the same time(s) each day for best results
- Swallow tablets/capsules whole unless instructed otherwise
- Don't skip doses
- Complete full course of treatment as prescribed
- Follow your doctor's specific instructions carefully
Important Safety Information
Who Should Not Take Digoxin?
Do not take Digoxin if you:
- Are allergic to Digoxin or any ingredients
- Have certain medical conditions (discuss with your doctor)
- Are taking medications that interact with Digoxin
- Have severe liver or kidney disease (without dose adjustment)
Drug Interactions
Inform your doctor about all medications you take, including:
- Prescription medications
- Over-the-counter drugs
- Vitamins and supplements
- Herbal products
Some medications may interact with Digoxin, affecting its efficacy or increasing side effect risk.
Pregnancy and Breastfeeding
Pregnancy:
- Discuss risks and benefits with your doctor if pregnant or planning pregnancy
- May require special monitoring or dose adjustments
- Some medications should be avoided during pregnancy
Breastfeeding:
- Consult your doctor about safety while breastfeeding
- May pass into breast milk
- Benefits and risks should be carefully considered
Monitoring and Follow-Up
While taking Digoxin, your doctor may monitor:
- Effectiveness of treatment (symptom improvement)
- Side effects or adverse reactions
- Laboratory values if applicable
- Blood pressure, heart rate, or other vital signs as appropriate
- Overall response to therapy
Regular follow-up appointments are important to ensure the medication is working properly and to make any necessary adjustments.
Managing Side Effects
Most side effects are mild and improve with time. Here are strategies for common side effects:
Gastrointestinal Upset
- Take with food if allowed
- Stay well hydrated
- Eat smaller, more frequent meals
- Report persistent nausea or vomiting
Dizziness
- Rise slowly from sitting or lying positions
- Avoid sudden movements
- Stay hydrated
- Avoid alcohol
- Report severe or persistent dizziness
Fatigue
- Get adequate rest
- Maintain regular sleep schedule
- Exercise as tolerated
- Report excessive tiredness that interferes with daily activities
Lifestyle Considerations
To maximize the benefits of Digoxin:
- Follow a healthy, balanced diet
- Exercise regularly as recommended by your doctor
- Maintain a healthy weight
- Avoid alcohol or limit consumption
- Don't smoke
- Manage stress through relaxation techniques
- Get adequate sleep
- Stay well hydrated
- Keep all follow-up appointments
- Take medication consistently as prescribed
When to Contact Your Doctor
Seek immediate medical attention if you experience:
- Signs of severe allergic reaction (difficulty breathing, severe rash, swelling)
- Chest pain or rapid heartbeat
- Severe dizziness or fainting
- Unusual bleeding or bruising
- Signs of liver problems (yellowing of skin/eyes, dark urine, severe fatigue)
- Severe stomach pain
- Any symptoms that concern you
Contact your doctor for non-emergency issues:
- Mild to moderate side effects that persist
- Questions about your medication
- Concerns about effectiveness
- New medications prescribed by another doctor
- Scheduled surgery or dental procedures
- Planning pregnancy
Storage
Store Digoxin at room temperature (68-77°F or 20-25°C) away from light, heat, and moisture. Keep in original container. Keep out of reach of children and pets. Do not use past expiration date.
Important Reminders
- Take exactly as prescribed by your doctor
- Don't stop suddenly without medical advice
- Keep all follow-up appointments
- Report any unusual symptoms
- Don't share medication with others
- Store safely away from children
- Check expiration dates
- Ask your pharmacist if you have questions
Clinical Benefits
When used appropriately, Digoxin provides several benefits:
- Effective management of heart failure and atrial fibrillation
- Improvement in quality of life
- Reduction in symptoms
- Prevention of complications
- Generally well-tolerated when used as directed
- Backed by clinical research and extensive use
Disclaimer: This information is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Always consult your physician or other qualified healthcare provider with any questions about a medical condition or medication.
Frequently Asked Questions
Questions to Ask Your Doctor About Digoxin
Consider discussing these topics at your next appointment:
- Why is digoxin being added to my regimen, and what symptoms should improve?
- How often will my digoxin level, kidney function, and electrolytes be checked?
- Which of my other medications interact with digoxin and might need adjustment?
- What symptoms should make me call you or go to the emergency department?
- Is there a heart failure or arrhythmia treatment that might work better for me with less risk?
Medical Disclaimer: This information is for educational purposes only and should not be considered medical advice. Always consult with your healthcare provider before starting, stopping, or changing any medication. Your doctor can provide personalized recommendations based on your specific health condition and medical history.