Digoxin

Digoxin is a cardiac glycoside which has positive inotropic activity characterized by an increase in the force of myocardial contraction. It also reduces the conductivity of the heart through the atrioventricular (AV) node. Digoxin also exerts direct action on vascular smooth muscle and indirect effects mediated primarily by the autonomic nervous system and an increase in vagal activity.

• Heart failure
• Atrial fibrillation with uncontrolled ventricular rate
• Acute and chronic left ventricular failure
• Congestive heart failure

Digoxin is a cardiac glycoside which has positive inotropic activity characterized by an increase in the force of myocardial contraction. It also reduces the conductivity of the heart through the AV node. Digoxin also exerts direct action on vascular smooth muscle and indirect effects mediated primarily by the autonomic nervous system.

Digoxin increases the force of myocardial contraction and reduces conduction through the AV node, improving cardiac function and controlling irregular heartbeats.

Adult (Rapid digitalization - Atrial Fibrillation): Total loading dose 10-15 mcg/kg; give 50% initially, then 1/4 of loading dose q6-8hr twice.
Adult (Maintenance): 3.4-5.1 mcg/kg/day or 0.125-0.5 mg/day PO.
Adult (Heart Failure): 0.125-0.25 mg PO/IV daily.
Children: Age and weight-based dosing (from premature neonates to >10 years).

Take at the same time each day with or without food. Swallow the tablet whole, do not chew, crush or break.

If you miss a dose of Digoxin, skip it and continue with your normal schedule. Do not double the dose.

Common: Nausea, vomiting, diarrhea, abdominal pain, headache, fatigue, drowsiness, confusion, delirium, hallucination, depression, arrhythmia, heart block.
Other: Visual disturbance, gynecomastia (long-term use), thrombocytopenia.

May affect driving ability (dizziness, vision changes, drowsiness). Be aware of overdose symptoms (slow heartbeat, dizziness, breathing problems). Do not stop abruptly.

Digitalis toxicity; ventricular tachycardia/fibrillation; obstructive cardiomyopathy; arrhythmias due to accessory pathways (e.g. Wolff-Parkinson-White syndrome).

Phenytoin, neomycin, sulphasalazine, kaolin, pectin, antacids, radiotherapy: Reduced effectiveness.
Metoclopramide: May alter absorption of solid dosage forms.
Calcium channel blockers, spironolactone, quinidine, calcium salts: Increased blood levels.
Potentially Fatal: Hypokalemia and hypomagnesemia increase risk of cardiac toxicity.

It is unsafe to consume alcohol with Digoxin.

Pregnancy Category C. Digoxin may be unsafe during pregnancy.

Digoxin is excreted in breast milk but at concentrations below those found in plasma; safe for breastfed infants.

Dosage is established for neonates and children (age and weight-based).

Elderly patients require a lower maintenance dose due to reduced renal function and increased tissue sensitivity.

Renal impairment: Use with caution; dose adjustment may be needed (lower end 0.125 mg/day).
Hepatic impairment: Probably safe; dose adjustment may not be needed.

Overdose may cause anorexia, nausea, diarrhea, visual disturbance, arrhythmia. Seek medical attention.

Store in a cool and dry place. Keep out of reach of children.

Digoxin