Digoxin

Therapeutic action

• Cardiotonic

Indications

• Supraventricular arrhythmias (fibrillation, flutter, paroxysmal tachycardia) 
• Heart failure

Forms and strengths

• 250 micrograms (0.25 mg) tablet

Dosage

• Adult: 125 to 250 micrograms(0.125 to 0.25 mg) once daily
• Reduce the dose by half in older patients and in patients with renal impairment.

Duration

• According to clinical response

Contra-indications, adverse effects, precautions

• Do not administer to patients with bradycardia, ill defined arrhythmia, coronary artery disease. It is essential to monitor heart rate in the initial stage of treatment.
• May cause in the event of overdose: gastrointestinal disturbances (nausea, vomiting, diarrhoea), blurred vision, headache, confusion, conduction and rhythm disorders. If so, reduce dose or stop treatment.
• Do not combine with calcium, particularly by IV route (serious arrhythmias). 
• Monitor combination with:
  • amiodarone, macrolides, itraconazole, quinine, chloroquine (increased digoxin concentration);
  • potassium-depleting drugs:diuretics, corticosteroids, amphotericin B (increased risk of digoxin toxicity).
• Monitor if possible serum potassium level in patients taking potassium-depleting drugs and serum creatinine level in patients with renal impairment.
• Do not administer simultaneously with antacids such as aluminium hydroxide, etc., administer 2 hours apart.
• Pregnancy: no contra-indication
• Breast-feeding: no contra-indication

Storage

– Below 25 °C