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DIGOXIN - a patient's guide
Editorial Team
Brand name: Lanoxin
Use: heart failure (with atrial fibrillation)
This medicine is called a cardiac glycoside which is indicated
for heart failure, especially in patients with atrial fibrillation
(heart 'flutter'). Digoxin has complex activity, where it
increases the contraction force of the heart but also slows
the rate at which the heart pumps (useful in fibrillation).
It also has a very low therapeutic index, because there
is a narrow difference between optimal therapeutic dose
and toxicity so special care is taken by your doctor when
prescribing digoxin.
Caution:
Previous digoxin (digitallis) toxicity
Elderly (special care with kidney impairment)
Hypokalaemia (low potassium levels causes toxicity)
Recent MI (heart attack)
Hypothyroidism
Pregnancy and breast-feeding (discuss with doctor)
Side effects:
Usually dose-related: anorexia (loss of appetite), abdominal
pain, stomach upset (nausea, diarrhoea), headache, fatigue,
drowsiness, mind disturbances (confusion, delirium, hallucinations).
Overdose: heart block and arrhythmias (disturbances in
the rhythm of the heart).
Interactions:
Increased toxicity with quinine, calcium-channel blockers,
anti-arrthymias and possibly ACE-Inhibitors. Hypokalemia
(low potassium levels) associated with diuretics, lithium
and corticosteroids give rise to increased toxicity. Antacids
and anion-exchange resins impair absorption of digoxin.
Patient information:
Follow the instructions carefully on the label of this
medicine
Do not stop taking this medicine unless directed by your
doctor
Food: take with food if this medicine upsets your stomach
or as directed
Antacids: take 6 hours apart to prevent impaired absorption
Missed dose: take the next dose as soon as you remember
(don't double dose)
Avoid taking other medicines unless directed by your doctor/pharmacist
Regular monitoring of plasma-digoxin levels maybe needed
if you are on diuretic therapy (discuss with doctor)
Contact your doctor or seek urgent medical help if side
effects occur or overdose is suspected.
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