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Digoxin is extracted from the leaves of a plant called digitalis lanata. Digoxin increases the strength and vigor of the heart muscle contractions, and is useful in the treatment of heart failure. Digoxin also slows the electrical conduction between the atria and the ventricles of the heart, and is useful in treating abnormally rapid atrial rhythms such as atrial fibrillation, atrial flutter, and atrial tachycardia.

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Brand Names: Lanoxin, Digitek and Lanoxicaps
Generic name: Digoxin

Abnormally rapid atrial rhythms can be caused by heart attacks, excessive thyroid hormones, alcoholism, infections, and many other conditions. During rapid atrial rhythms, electrical signals from the atria cause rapid contractions of the ventricles. Rapid ventricle contractions are inefficient in delivering oxygen and nutrients to the body, causing symptoms of weakness, shortness of breath, dizziness, and even chest pain. Digoxin alleviates these symptoms by blocking the electrical conduction between the atria and ventricles, thus slowing ventricle contractions.

Digoxin is used to treat congestive heart failure and the associated symptoms of shortness of breath when lying flat, wheezing, and ankle swelling. Digoxin is also used to slow heart rate in rapid atrial rhythm disturbances such as atrial fibrillation and atrial flutter.

Digoxin may be taken with or without food. Digoxin is mainly excreted by the kidneys, and dosages need to be reduced in patients with kidney dysfunction. Digoxin blood levels can be used to monitor dosing and to avoid drug toxicity.

There is little cushion between a therapeutically beneficial level of digoxin and a toxic level of digoxin. Digoxin toxicity is common, especially in patients with kidney dysfunction. Digoxin toxicity can cause potentially life- threatening heart rhythm disturbances, ranging from very slow to rapid ventricular rhythms. In patients with existing disease of the electrical conduction of the heart, digoxin can precipitate heart block and a seriously slow heart rate.

Patients with low blood potassium levels can develop digoxin toxicity even when digoxin levels are not considered elevated. Similarly, high calcium and low magnesium blood levels can increase digoxin toxicity and produce serious heart rhythm disturbances. Drugs such as quinidine (Quinaglute, Quinidex), verapamil (Calan), and amiodarone (Cordarone) can increase digoxin levels and the risk of toxicity. The co-administration of digoxin and beta blockers, such as propranolol (Inderal Inderal LA), or calcium channel blockers, such as Calan, can cause serious slowing of the heart rate.

When digoxin is taken by patients receiving saquinavir (Fortovase, Invirase) with ritonavir (Norvir), the amount of digoxin in the body can increase by 50%, possibly leading to side effects such as potentially fatal rhythm disturbances, nausea, vomiting, and diarrhea, blurred or yellow vision; headache; weakness; dizziness; apathy; confusion; and mental disturbances such as anxiety, depression, delirium, and hallucinations.

The most common side effects are related to digoxin toxicity and heart rhythm disturbances. Other side effects include abdominal pain, nausea, vomiting, loss of appetite, breast enlargement, skin rash, blurred vision, and mental changes.

Digoxin works directly on the heart muscle to strengthen and regulate the heartbeat. It is used to treat certain heart conditions.

This medication is best taken on an empty stomach one hour before or two hours after meals. It may be taken with food if stomach upset occurs. Try to take it at the same time(s) each day, exactly as directed. Foods high in fiber may decrease the absorption of digoxin into your bloodstream. Take digoxin at least two hours before or after eating food products high in fiber (such as bran). Do not stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is suddenly stopped.

Diarrhea, loss of appetite, drowsiness, headache, muscle weakness, and fatigue may occur as your body adjusts to the medication. Inform your doctor if you develop: confusion, visual disturbances (blurred vision or yellow/green halos around objects), fast/slow/irregular heartbeat, skin rash, breast enlargement, severe stomach upset. If you notice other effects not listed above, contact your doctor or pharmacist.

Tell your doctor if you have a history of: liver or kidney disease, lung disease, thyroid problems, rheumatic fever. Difficulty breathing and swelling in your lower legs and ankles may be signs that your dose is too low. If normal activity causes shortness of breath or if you awaken frequently during the night due to shortness of breath, tell your doctor. Do not change your dose without consulting your doctor. Before having surgery, including dental surgery, tell the doctor that you take digoxin. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. Digoxin is excreted into breast milk. Though, to date, no problems have been noted in nursing infants, consult your doctor before breast-feeding.

This drug is shipped in blisters.

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