Precautions and warnings

Heart rhythm problems, low potassium, high blood pressure, heart disease, high calcium, low magnesium, electrical heart treatments, long-term lung-related heart problems, aortic valve disease, sudden heart inflammation, heart failure, stiff heart lining, heart block, older age, kidney problems, thyroid issues, and pregnancy are all things to consider. IV digoxin should only be given to patients who have not taken any cardiac glycosides in the past two weeks.

Drug Interactions

The effectiveness of this medicine may be reduced if you take phenytoin, neomycin, sulphasalazine, kaolin, pectin, antacids, or if you are undergoing radiotherapy. Metoclopramide may affect how your body absorbs digoxin tablets. Blood levels of digoxin can increase if you also take calcium channel blockers, spironolactone, quinidine, or calcium supplements.

Warning: Low levels of potassium or magnesium in your blood (for example, from using certain diuretics or corticosteroids) can raise the risk of serious heart problems.

Contraindications

Do not use in cases of digitalis (digoxin) toxicity, certain fast or irregular heart rhythms like ventricular tachycardia or fibrillation, or if someone has obstructive cardiomyopathy. Avoid use when abnormal heart rhythms are caused by extra electrical pathways, such as in Wolff-Parkinson-White (WPW) syndrome.

Mode of actions

Digoxin is a medication that helps the heart beat more strongly by increasing the force of its contractions. It also slows down how quickly signals pass through the heart’s AV (atrioventricular) node, helping to control the heart rate. In addition, Digoxin acts directly on the blood vessels’ muscles and has indirect effects through the nervous system, mainly by boosting vagal (parasympathetic) activity.

Dosage & Administration

Adult: PO Heart failure; Supraventricular arrhythmias Rapid digitalisation: Loading dose: 0.75-1.5 mg in the 1st 24 hr. Slow digitilisation: 250 mcg 1-2 times/day. Uusal maintenance: 125-250 mcg/day.

Child: Neonate 2.5 kg and child 1 mth-2 yr: Initial: 45 mcg/kg/day in 3 divided doses for 24 hr, then 10 mcg/kg/day in 1-2 divided doses. 2-5 yr: Initial: 35 mcg/kg/day in 3 divided doses for 24 hr, then 10 mcg/kg/day in 1-2 divided doses. 5-10 yr: Initial: 25 mcg/kg/day (max: 750 mcg/day) in 3 divided doses for 24 hr, then 6 mcg/kg/day (max: 250 mcg/day) in 1-2 divided doses. 10-18 yr: Initial: 0.75-1.5 mg/day in 3 divided doses for 24 hr, then 62.5-750 mcg/day in 1-2 divided doses. Reduce doses if patient has been given cardiac glycoside in the preceding 2 wk.

Adult: IV Emergency heart failure For patients who have not received cardiac glycosides in the previous 2 wk: 0.5-1 mg via infusion as a single dose or in divided doses. Maintenance: Usually via oral admin.

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.

Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.

This medicine passes into breast milk. Talk to your doctor before breastfeeding.

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