$Unique_ID{BRK03130} $Pretitle{} $Title{digoxin} $Subject{Lanoxicaps Burroughs Wellcome Lanoxin Cardiac glycoside digoxin heart arrhythmias congestive failure muscle heartbeat rhythm contraction} $Volume{} $Log{ Lanoxin 0.125 mg*0313001.scf Lanoxin 0.25 mg*0313002.scf} Copyright (C) 1993 Publications International, Ltd. digoxin ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) digoxin (various manufacturers) Lanoxicaps (Burroughs Wellcome) Lanoxin (Burroughs Wellcome) TYPE OF DRUG Cardiac glycoside INGREDIENT digoxin DOSAGE FORMS Tablets (0.125 mg, 0.25 mg, and 0.5 mg) Capsules (0.05 mg, 0.1 mg, and 0.2 mg) Pediatric elixir (0.05 mg per ml, with 10% alcohol) STORAGE Digoxin tablets, capsules, and pediatric elixir should be stored at room temperature in tightly closed, light-resistant containers. This medication should never be frozen. USES Digoxin is used to treat heart arrhythmias and congestive heart failure. It works directly on the muscle of the heart to strengthen the heartbeat and improve heart rhythm and contraction. TREATMENT To avoid stomach irritation, take digoxin with water or with food. Try to take it at the same time every day. Measure the dose of the pediatric elixir carefully with the dropper provided. An ordinary kitchen teaspoon is not accurate enough. Antacids decrease the absorption of digoxin from the gastrointestinal tract. Therefore, if you are taking both digoxin and an antacid, the dose of digoxin should be taken one hour before or two hours after a dose of antacids. Try not to miss any doses of this medication. If you do miss a dose, take the missed dose as soon as possible, unless it is almost time for the next dose. In that case, do not take the missed dose at all; just return to your regular dosing schedule. Do not double the next dose. If you miss more than two doses of digoxin, contact your doctor. Digoxin does not cure congestive heart failure, but it will help to control the condition as long as you continue to take the medication. SIDE EFFECTS Minor. Apathy, diarrhea, drowsiness, headache, muscle weakness, or tiredness. These side effects should disappear as your body adjusts to the medication. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about disorientation, enlarged and painful breasts (in both sexes), hallucinations, loss of appetite, mental depression, nausea, palpitations, severe abdominal pain, slowed heart rate, visual disturbances (such as blurred or yellow vision), or vomiting. INTERACTIONS Digoxin interacts with several other types of medications (interactions may vary depending upon the dosage form of digoxin being used): 1. Penicillamine, antiseizure medications, rifampin, amino-glutethimide, and levodopa can decrease the blood levels and, therefore, the effectiveness of digoxin. 2. Erythromycin, amiodarone, captopril, benzodiazepine tranquilizers, flecainide, tetracycline, hydroxychloroquine, ibuprofen, indomethacin, verapamil, nifedipine, diltiazem, quinidine, quinine, and spironolactone can increase the blood levels of digoxin, which can lead to an increase in side effects. 3. Thyroid hormone, propylthiouracil, and methimazole can change the dosage requirements of digoxin. 4. Antacids, kaolin-pectin, sulfasalazine, aminosalicylic acid, metoclopramide, antineoplastic agents (anticancer drugs), neomycin, colestipol, and cholestyramine can decrease the absorption of digoxin from the gastrointestinal tract, decreasing its effectiveness. 5. Calcium, tolbutamide, and reserpine can increase the side effects of digoxin. 6. Diuretics (water pills) and adrenocorticosteroids (cortisone-like medications) can cause hypokalemia (low potassium blood levels). BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to digoxin, digitoxin, or any other digitalis glycoside. * Tell your doctor if you now have or if you have ever had kidney disease, lung disease, thyroid disease, hypokalemia (low blood levels of potassium), or hypercalcemia (high blood levels of calcium). * The pharmacologic activity of the different brands of this drug varies widely--the tablets dissolve in the stomach and bowel at different rates and to varying degrees. Because of this variability, it is important not to change brands of the drug without consulting your doctor. * Meals high in bran fiber may reduce the absorption of digoxin from the gastrointestinal tract. Avoid these types of meals when taking your dose of medication. * Your doctor may want you to take your pulse daily while you are using digoxin. Contact your doctor if your pulse becomes slower than what your doctor tells you is normal, or if it drops below 50 beats per minute. * Before having surgery or any other medical or dental treatment, be sure to tell your doctor or dentist that you are taking this medication. * Before taking any over-the-counter (nonprescription) asthma, allergy, cough, cold, sinus, or diet product, be sure to check with your doctor or pharmacist. Some of these drugs can increase the side effects of digoxin. * Be sure to tell your doctor if you are pregnant. Although this drug appears to be safe during pregnancy, extensive studies in humans have not been conducted. In addition, the dosage of digoxin required to control your symptoms may change during pregnancy. Also, tell your doctor if you are breast-feeding an infant. Small amounts of digoxin pass into breast milk. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.