Digoxin

Digoxin
(Cardiac Drugs)

Dosage form	Brand	Strength
Tablet	Lanoxin TAB ®	250 mg

Indication : Tx of mild-to-moderate heart failure, atrial fibrillation, supraventricular tachycardia

Mechanism of action : Heart failure; inhibition of the Na⁺/K⁺ ATPase pump in myocardial cell

supraventricular tachycardia ; direct suppression of the AV node conduction

Pregnancy Category C

Contraindication : Hypersensitivity to Digoxin (rare), ventricular fibrillation

Precaution :

-Avoid use in patient with second-or third-degree heart block and hypertrophic cardiomyopathy

-Should not be use in patient with low EF, sinus rhythm and no heart failure symptom

-Withdrawal in heart failure patient may lead to recurrent of heart failure symptoms

Drug Interaction :

-Increase level of digoxin ; Amiodarone, Atorvastatin ,Beta Blocker, Ca²⁺ Channel Blocker, Macrolide Antibiotics ,Anti-inflammatory Agents, K⁺ Sparing Diuretic

-Decrease level of digoxin ; 5-ASA , Aminoglycosides , Anthracycline , K⁺ Sparing Diuretic

-Digoxin increase level of Adenosine ,Colchicine ,Dronedarone and Midodrine

-Digoxin decrease level of Anthracycline

Side Effect : Tachycardia, ventricular fibrillation, dizziness ,headache ,rash ,n/v ,diarrhea ,blurred vision

Monitoring parameters : Heart rate ,heart rhythm .serum creatinine, K⁺ , Mg²⁺ , Ca²⁺ ,serum digoxin concentrations

Usual Dose :

                -Heart failure; 0.125-0.25 mg once daily (use maintenance dose only)

-Atrial fibrillation ;0.5 mg once daily for 2 days followed maintenance dose 0.125-0.375 mg once daily

-Supraventricular tachycardia ; 0.75-1.5 mg , daily maintenance dose 0.125-0.25 mg once daily

Patient Education : Take as directed; do not discontinue without consulting prescriber. Maintain adequate dietary intake of potassium. Take pulse at the same time each day. Notify prescriber of acute changes in pulse. Report loss of appetite, nausea, vomiting, persistent diarrhea.

Missed Dose : Take it as soon as you remember if it is within 12 hours of your scheduled dose. If it is more than 12 hours after your scheduled dose, skip the missed dose and resume your usual dosing schedule.

Auxiliary labels  : Notify your physician if loss of appetite or visual changes.