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Before taking digoxin, tell your doctor if you are taking any of the following medicines:

• another medication for irregular heartbeats, such as quinidine (Quinidex, Quinora, Cardioquin, others), amiodarone (Cordarone), or propafenone (Rythmol);

• an antacid or laxative that contains aluminum, magnesium, or kaolin-pectin such as Maalox, Rolaids, Mylanta, Milk of Magnesia, and others;

• a beta-blocker such as atenolol (Tenormin), propranolol (Inderal), acebutolol (Sectral), metoprolol (Lopressor), carteolol (Cartrol), labetalol (Normodyne, Trandate), or nadolol (Corgard);

• a calcium channel blocker such as diltiazem (Cardizem, Dilacor XR, Tiazac), amlodipine (Norvasc), felodipine (Plendil), nifedipine (Procardia, Adalat), verapamil (Verelan, Calan, Isoptin, Covera-HS), and others;

• a cancer chemotherapy drug;

• a diuretic (water pill) such as hydrochlorothiazide (HCTZ, HydroDiuril, others), chlorothiazide (Diuril), chlorthalidone (Hygroton, Thalitone), furosemide (Lasix), torsemide (Demadex), bumetanide (Bumex), ethacrynic acid (Edecrin), triamterene (Dyrenium, Maxzide, Dyazide), amiloride (Midamor), spironolactone (Aldactone), eplerenone (Inspra), and others;

• a steroid medicine such as prednisone (Deltasone), methylprednisolone (Medrol, others), prednisolone (Prelone, Pediapred, others), dexamethasone (Decadron), and others;

• a thyroid medication;

• alprazolam (Xanax);

• amphotericin B (Fungizone);

• cholestyramine (Questran, Prevalite) or colestipol (Colestid);

• erythromycin (E.E.S., E-Mycin, Eryc, Ery-Tab, PCE, others) or clarithromycin (Biaxin);

• indomethacin (Indocin);

• itraconazole (Sporanox);

• metoclopramide (Reglan);

• rifampin (Rifadin, Rimactane);

• sulfasalazine (Azulfidine); or

• tetracycline (Broadspec, Emtet, Panmycin, Sumycin, Tetracap, others).

You may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with digoxin or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

If you experience any of the following serious side effects, stop taking digoxin and seek medical attention or contact your doctor immediately:

• an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

• a severe headache, fainting, or extreme drowsiness or dizziness;

• irregular heartbeats;

• slow heartbeats (fewer than 60 beats per minute);

• abnormally fast heartbeats;

• vision changes (e.g., yellow-green or blurred vision);

• hallucinations; or

• abnormal or psychotic behavior.

If you experience any of the following less serious side effects, continue to take digoxin and talk to your doctor if you experience

• decreased appetite and diarrhea;

• unusual tiredness or weakness;

• depression;

• nausea or vomiting;

• drowsiness or dizziness;

• decreased sex drive; or

• enlarged breasts in males.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.