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What is digoxin?
Digoxin helps the heart to beat more strongly and regularly. Digoxin is used to treat conditions such as congestive heart failure and atrial fibrillation/atrial flutter (types of fast heartbeats). Digoxin may also be used for purposes other than those listed in this medication guide.

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What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

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What are the possible side effects of digoxin?

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.

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How should I take digoxin?
Take digoxin exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you. Take each dose with a full glass of water. Try to take digoxin at the same time every day. Ask your doctor to teach you how to monitor your heart rate and at what heart rate you should notify them before taking any more medication. Do not stop taking digoxin suddenly. Stopping suddenly could make your condition worse. Even if you feel better, you may need to keep taking this medication to help the heart work properly. Make sure you always have enough digoxin on hand for vacations and holidays.

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What is the most important information I should know about digoxin?
Do not stop taking digoxin suddenly. Stopping suddenly could make your condition worse. Even if you feel better, you need to keep taking this medication to help the heart work properly. Make sure you always have enough digoxin on hand for vacations and holidays. Ask your doctor to teach you how to monitor your heart rate and at what heart rate you should notify them before taking any more medication.

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What happens if I miss a dose?
Take the missed dose up to 12 hours late. If more than 12 hours have passed, skip the missed dose and take only the next regularly scheduled dose. Do Not take a double dose of this medication.

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What other drugs will affect digoxin?
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);

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Digoxin has been assigned to FDA pregnancy category C by the FDA. Animal studies failed to reveal evidence of teratogenicity. There are no controlled data in human pregnancy. Digoxin has been used successfully to treat maternal congestive heart failure and arrhythmias and fetal arrhythmias throughout gestation without reports of fetal harm, however, digoxin should be given during pregnancy only when benefit outweighs risk.

There are no reports of congenital defects associated with digoxin. Digoxin crosses the placenta with increasing fetal accumulation throughout gestation. Umbilical cord concentrations reported have been 50%, 81%, and 83% of maternal serum levels. The fetal heart has a limited ability to bind digoxin during the first half of human gestation, but concentrates digoxin in the second half. Fetal and neonatal tolerance is greater (2 to 4 ng/mL) than that of adults (less than 2 ng/mL). Monitoring of serum digoxin levels, both antepartum and postpartum, is recommended as maternal plasma clearance of digoxin is significantly increased during pregnancy.

Digoxin is excreted into human milk, however, nursing infant exposure is limited. Pharmacologic and/or adverse effects are not anticipated. However, the manufacturer recommends caution when administering digoxin to nursing women.

Digoxin milk to maternal serum concentration ratios of 0.6 to 0.9 have been reported. Data from two women taking digoxin 0.25 mg daily revealed mean peak digoxin milk levels of 0.61 to 0.96 ng/mL at 4 and 6 hours after dosing, respectively. The mean digoxin milk levels in these two patients were 0.78 and 0.41 ng/mL, respectively. Digoxin could not be detected in the plasma of either nursing infant (radioimmunoassay sensitivity of 0.1 ng/mL). The authors calculated that should the nursing infants consume 150 mL of milk/kg/day, the digoxin burden would be 0.12 and 0.06 mcg/kg/day, respectively. These amounts are associated with subtherapeutic neonatal levels. A case in which a mean milk digoxin level of 1.9 ng/mL was similar to the maternal plasm level has been reported. The mother was taking digoxin 0.75 mg daily. This milk digoxin level is considerably higher than other levels reported, however, the digoxin burden to the nursing infant was reported as 0.2 ng/mL.

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Who should NOT use this medication?

• Ventricular fibrillation
• Known hypersensitivity to digoxin or other digitalis preparations

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What does my medication look like?
Digoxin is available with a prescription under the brand names Lanoxin, Lanoxicaps, Cardoxin, and Digitek. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you. Lanoxin Pediatric Elixir 0.05 mg/1 mL Lanoxin 0.125 mg--yellow, round, scored tablets Lanoxin 0.250 mg--white, round, scored tablets Lanoxicaps 0.05 mg--red, hard-gelatin capsules Lanoxicaps 0.1 mg--yellow, hard-gelatin capsules Lanoxicaps 0.2 mg--green, hard-gelatin capsules

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What happens if I overdose?
Seek emergency medical attention. Symptoms of a digoxin overdose include nausea, vomiting, decreased appetite, diarrhea, confusion, seizures, hallucinations, light "halos" around objects, green or yellow vision, fatigue, irregular heartbeats, and abnormally fast or slow heartbeats.

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What should I discuss with my healthcare provider before taking digoxin?
Before taking this medication, tell your doctor if you: have kidney disease; have thyroid disease, or are taking any other heart medication. You may require a dosage adjustment or special monitoring while taking digoxin. Digoxin is in the FDA pregnancy category C. This means that it is not known whether digoxin will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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