Digoxin is a cardiac glycoside that is prescribed to treat chronic heart failure and chronic atrial fibrillation or flutter.




10, 28, 50

Novartis, Actavis, GSK


0.125 mg, 0.25 mg

India, Turkey


I. Introduction

The use of Digoxin in medicine can be traced back to the century when it was first derived from the foxglove plant. This natural compound, extracted from the leaves of Digitalis lanata has had an impact on cardiovascular treatment. The foxglove plant, known for its purple flowers, caught the attention of researchers because of its remarkable effects on heart function. In today's medicine, Digoxin plays a crucial role in cardiology. It is not only valued for its historical significance but also for its essential contribution to managing various heart conditions. The effectiveness of this medication has positively impacted lives and continues to be relied upon by medical professionals.

II. Uses of Digoxin

Heart failure, a condition in which the heart has difficulty pumping blood effectively, often necessitates the use of medications for treatment. Digoxin comes into play by enhancing the strength of the heart's contractions. This ensures blood circulation, bringing relief to patients. Atrial fibrillation and flutter are heart rhythm disorders that disrupt the coordinated beats of the heart. Digoxin, with its mechanism of action, helps restore a stable and regular heartbeat.


Digoxin is used to treat congestive heart failure, usually in combination with a diuretic (water pill) and an angiotensin-converting enzyme (ACE) inhibitor.

American Heart Association


III. How Digoxin Works

Digoxin works primarily by blocking the sodium-potassium ATPase pump in the heart. This action leads to levels of sodium inside the cells, which in turn increases calcium levels. These elevated calcium levels help strengthen the contractions of the heart muscles. The balance between calcium and sodium is crucial for heart function, and Digoxin regulates these ions to not only enhance contraction force but also maintain control over heart rhythm.

IV. Off-label Uses of Digoxin

Treating supraventricular tachycardia is intriguing because Digoxin plays a role in it. When given to the mother, it can cross the barrier and regulate the heart rate of the fetus. Digoxin's versatility goes beyond its known uses and extends to treating rare cardiac conditions like refractory ventricular tachycardia. Additionally, there is research exploring Digoxin's potential benefits in noncardiac disorders, particularly certain neurological and metabolic disorders. This indicates that Digoxin may have a range of therapeutic applications beyond cardiology.


Supraventricular tachycardia

Refractory ventricular tachycardia

Neurological disorders

V. Dosage and Administration

Dosage Recommendations for Conditions For Heart Failure: Take between 0.125 to 0.5 mg daily. For Atrial Fibrillation, Begin with a dose of 0.5 mg followed by maintenance doses. Frequency of Administration: Generally, the medication is taken once a day. It may vary depending on the patient's kidney function and serum levels. Regular monitoring is necessary to ensure the effectiveness. Adjustments for Renal Impairments: Individuals with impaired kidney function require a dosage. The clearance of Digoxin in the kidneys plays a role, in its metabolism so careful adjustments are necessary to prevent toxicity.

VI. Composition of Digoxin

Digoxin derives its effectiveness from a component called cardenolide glycoside. This ingredient is crucial in delivering the intended effects. In addition to the elements, Digoxin tablets contain various inactive details such as binders, fillers, and colorants. These additional ingredients play a role in ensuring the tablet's stability, shape, and overall appearance.

VII. Common Side Effects

Patients may experience disturbances such as nausea, vomiting, or diarrhea. These symptoms are pretty standard. Should be taken care of to prevent them from worsening. Some patients might notice changes in their vision, like a tint or seeing halos around objects. If you experience these alterations, known as xanthopsia, it is advisable to seek medical advice. Interestingly, while Digoxin treats arrhythmias, taking doses can lead to cardiac arrhythmias. Regular monitoring is crucial to prevent these effects.

VIII. Less Common and Severe Side Effects

The effects on the nervous system, such as confusion, dizziness, or hallucinations, indicate how Digoxin affects our nerves. If any of these symptoms occur, it is essential to review the dosage of the medication. Skin-related side effects like rashes or hives may appear, indicating a reaction to the drug. In some cases, it is crucial to stop taking the medication immediately and seek medical attention. Digoxin can potentially disrupt potassium levels in our body, leading to either hyperkalemia or hypokalemia. Regular monitoring of levels helps ensure that any imbalances are quickly corrected.

IX. Interaction with Other Medications

Certain drugs can affect the way Digoxin works in the body, potentially leading to levels of Digoxin in the bloodstream and increasing the risk of toxicity. Some medications that can have this effect include Amiodarone, which alters how Digoxin is cleared from the body; Verapamil, which can increase Digoxin levels in the blood; and certain types of antibiotics called macrolides, which may enhance the absorption of Digoxin. On the other hand, some medications can reduce or weaken the therapeutic effects of Digoxin. Examples include antacids, which may interfere with how the body absorbs Digoxin, and Rifampin, a drug that increases metabolism and decreases effectiveness. When patients are taking Digoxin along with medications, it becomes crucial to regularly monitor their blood levels of Digoxin through serum level checks. Additionally, assessing symptoms and conducting evaluations are essential measures. Depending on these assessments and watching results, dosage adjustments or longer intervals between monitoring may be necessary.

X. Warning and Contraindications

Instances of reactions to Digoxin are rare but essential to address promptly and manage symptoms. These reactions may include rashes, itching, or even anaphylaxis. It is crucial to exercise caution when prescribing Digoxin to patients with renal impairment, as their kidneys may have difficulty excreting the drug, leading to increased serum concentrations and potential toxicity. Additionally, individuals with arrhythmic conditions like ventricular fibrillation should avoid taking Digoxin due to the risk of worsening their condition.

XI. Careful Administration and Monitoring

To prevent any harm and ensure that the treatment is effective, it is crucial to monitor the levels of Digoxin in the blood regularly. This is particularly important after starting the medication or making dosage adjustments. It is also necessary to check the patient's electrocardiogram (ECG) and electrolyte levels, especially potassium, as this helps us understand how Digoxin affects the heart and metabolism, ensuring that it is administered safely.

XII. Important Precautions

When taking Digoxin, it is essential to maintain an intake of potassium-rich foods. Sudden changes in potassium levels can lead to toxicity. Some examples of foods high in potassium include bananas, spinach, and potatoes. It is crucial to be able to identify the signs of Digoxin toxicity, such as experiencing nausea, visual problems, or palpitations. Recognizing these symptoms allows for prompt intervention and helps prevent complications from arising.

XIII. Special Populations: Administration and Precautions

a. When it comes to individuals, their dosage of medication often needs to be adjusted due to changes in how their bodies process drugs. It's also important to be extra cautious about side effects since they are more susceptible. b. When administering Digoxin to pregnant women, it's crucial to weigh the risks and benefits. While the drug can cross the placenta, its impact on health is still uncertain. For nursing mothers, it's essential to consider the excretion of Digoxin in breast milk and assess any exposure for the infant. c. When it comes to children, specific dosages of Digoxin should be determined based on their age. Due to their pharmacokinetic profile and vulnerability, close monitoring is necessary to ensure safety and effectiveness.

XIV. Overdosage

Signs of taking much Digoxin When someone takes an excessive amount of Digoxin, they may experience various symptoms. These can include stomach problems, changes in vision, and dangerous irregular heartbeats. It's essential to identify these symptoms for the best possible outcomes. What to do if you suspect an overdose If you think someone has taken too much Digoxin, it's crucial to seek immediate medical help. Treatment may involve using activated charcoal, providing antidotes, like Digoxin-specific antibody fragments, and giving supportive care.

XV. Storage and Handling Precautions

To maintain the stability and effectiveness of Digoxin, it is essential to store it in a dry location away from sunlight and moisture. Additionally, it is crucial to keep it out of reach of children and pets. When Digoxin reaches its expiration date, using it can potentially reduce its efficacy. Therefore, it is necessary to dispose of expired or unneeded Digoxin following guidelines to prevent environmental contamination and potential hazards to others.

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