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Home > Drug Category > Myocardial Infarct Medications, Cardiovascular Treatments > Digoxin and Equivalent

Digoxin Information

Digoxin is a cardiac glycoside used to treat mild to moderate heart failure and to control the ventricular response rate in patients with chronic atrial fibrillation. It works by inhibiting the sodium-potassium ATPase in myocardial cells, thereby increasing intracellular calcium concentration and strengthening cardiac muscle contraction (positive inotropic effect). Additionally, it slows electrical conduction through the atrioventricular (AV) node (negative dromotropic effect), helping to slow and stabilize an irregular, fast heart rate (negative chronotropic effect).

Side Effects

Commonly reported side effects include mild nausea, vomiting, loss of appetite (anorexia), diarrhea, headache, dizziness, drowsiness, and mild skin rashes.

Contact your doctor if you have any of the serious side effects, including:
• Cardiac Arrhythmias: Can induce new or worsening irregular heartbeats, including dangerous ventricular tachycardia, heart block, or severe bradycardia (abnormally slow heart rate).
• Digoxin Toxicity: A narrow therapeutic window can lead to dangerous toxicity levels, often presenting as severe nausea, vomiting, and a complete loss of appetite.
• Neurological Disturbances: Confusion, hallucinations, depression, extreme weakness, or disorientation, particularly in elderly patients.
• Visual Disturbances: Distinctive visual changes, such as blurred vision, double vision, or seeing halos around objects with a yellow, green, or white tint (xanthopsia).

Seek medical attention immediately if you experience sudden dizziness or fainting, an unusually slow or irregular heartbeat, severe weakness, confusion, or changes in your vision (such as seeing yellow-green halos). You must also contact your doctor if you experience persistent vomiting or inability to keep food down, which can indicate toxic buildup. Do not stop taking this medication suddenly without consulting your doctor, as abruptly discontinuing Digoxin can cause a sudden and severe worsening of your heart failure or atrial fibrillation symptoms.

Precautions:

Do not use Digoxin if you have a known hypersensitivity or prior serious allergic reaction to Digoxin, other digitalis glycosides, or any of the inactive ingredients in the tablet formulation. Tell your doctor about your medical history, especially if you have:
o Hypertrophic cardiomyopathy or severe aortic stenosis.
o Recent heart attack (acute myocardial infarction) or thyroid disorders.
o Severe electrolyte imbalances, specifically hypokalemia (low potassium), hypomagnesemia (low magnesium), or hypercalcemia (high calcium).
o Severe kidney disease or renal impairment.
o Ventricular fibrillation or ventricular tachycardia (unless caused by heart failure).
o Wolff-Parkinson-White syndrome with atrial fibrillation.

Digoxin has extensive, clinically critical drug interactions. Medications such as amiodarone, quinidine, verapamil, diltiazem, cyclosporine, and certain antibiotics (such as erythromycin and clarithromycin) can dramatically increase digoxin blood levels and the risk of toxicity. Diuretics, especially loop diuretics (like furosemide) and thiazides, can cause potassium loss, which severely enhances Digoxin's toxic effects on the heart. Conversely, antacids, metoclopramide, and cholestyramine can bind to Digoxin and reduce its absorption.

Digoxin crosses the placenta and has been used safely for decades during pregnancy to treat maternal and fetal heart conditions when clearly indicated; however, dosing requirements may change, and close monitoring is required. Digoxin is excreted into breast milk in very small amounts that are generally considered compatible with breastfeeding. It is recommended to speak to your doctor immediately if you are planning to get pregnant.

Regular blood tests (serum digoxin levels) and periodic electrocardiograms (ECGs) are necessary to verify that the medication remains within a safe, effective therapeutic window. Electrolyte panels (especially potassium levels) should also be routinely monitored.

Store Digoxin tablets at controlled room temperature (20°C to 25°C) in a dry place. Keep the container tightly closed and protect it from light and moisture. Always store this medication securely out of the reach of children and pets, as even a small accidental overdose can be life-threatening.

Do I need a prescription to order Digoxin?

Yes, a prescription is required from your physician to order Digoxin.