What are the common side effects of digoxin. How can patients manage digoxin side effects effectively. When should patients seek immediate medical attention while taking digoxin. What precautions should be taken when using digoxin.

Understanding Digoxin: Uses and Importance

Digoxin is a crucial medication used to treat various heart conditions, including atrial fibrillation and heart failure. It’s available as both brand-name (Lanoxin) and generic versions, in oral tablet and solution forms. This medication plays a vital role in managing cardiac issues for both adults and children.

Why is digoxin prescribed? Primarily, it’s used for:

• Treating atrial fibrillation
• Managing mild to moderate heart failure in adults
• Addressing heart failure in pediatric patients

As with any medication, understanding its effects and potential side effects is crucial for patients and caregivers. While digoxin can be highly effective, it’s important to be aware of its impact on the body and how to manage any adverse reactions.

Common Side Effects of Digoxin

Digoxin, like all medications, can cause side effects in some patients. These effects occur in more than 1 in 100 people taking the drug. It’s important to note that certain groups, including children, older adults, and those with kidney disease or hypothyroidism, may be more sensitive to digoxin’s effects.

What are the most common side effects of digoxin?

• Dizziness
• Nausea and vomiting
• Diarrhea
• Vision changes (blurred vision, sensitivity to light)
• Skin rashes

While these side effects can be uncomfortable, there are ways to manage them effectively. Let’s explore each one in more detail.

Managing Dizziness

Feeling dizzy is a common side effect of digoxin. How can patients cope with this symptom?

• Lie down immediately if you feel dizzy to prevent fainting
• Sit until the dizziness subsides before standing up
• Avoid driving, cycling, or operating machinery while experiencing dizziness

Dealing with Nausea and Vomiting

Nausea and vomiting can be distressing side effects. What strategies can help manage these symptoms?

• Stick to simple, bland meals
• Avoid rich or spicy foods
• Stay hydrated by drinking plenty of fluids
• Take small, regular sips of water if vomiting occurs

For patients with heart failure, it’s crucial to consult with a doctor about fluid intake, as restrictions may apply.

Coping with Diarrhea

Diarrhea can lead to dehydration if not managed properly. How should patients handle this side effect?

• Increase fluid intake to prevent dehydration
• Watch for signs of dehydration (reduced urination, dark urine)
• Consult a healthcare provider before taking any anti-diarrheal medications

Again, patients with heart failure should discuss fluid intake with their doctor.

Managing Vision Changes

Digoxin can cause visual disturbances. What precautions should patients take?

• Avoid driving or operating machinery until vision returns to normal
• Use caution in bright light environments
• Report persistent vision changes to a healthcare provider

Addressing Skin Rashes

Skin rashes can be uncomfortable and concerning. How should patients handle this side effect?

• Consult a pharmacist or doctor for recommended treatments
• Monitor the rash for any signs of worsening or spreading
• Report severe or persistent rashes to a healthcare provider

Recognizing Signs of Digoxin Toxicity

While common side effects are generally manageable, it’s crucial to be aware of signs that may indicate digoxin toxicity. This condition occurs when there’s too much digoxin in the blood and can be serious if left untreated.

How can patients recognize potential digoxin toxicity?

• Experiencing more than two of the common side effects simultaneously
• Rapid heart rate (palpitations)
• Shortness of breath
• Severe dizziness or lightheadedness

If these symptoms occur, it’s essential to seek immediate medical attention. Patients should contact their healthcare provider or emergency services without delay.

Serious Side Effects and Allergic Reactions

While rare, some patients may experience serious side effects or allergic reactions to digoxin. These situations require immediate medical intervention.

What are the signs of a serious allergic reaction to digoxin?

• Skin rash (itchy, red, swollen, blistered, or peeling)
• Wheezing
• Tightness in the chest or throat
• Difficulty breathing or talking
• Swelling of the mouth, face, lips, tongue, or throat

If any of these symptoms occur, patients should seek emergency medical care immediately. These could be signs of anaphylaxis, a severe allergic reaction that requires prompt treatment.

Special Considerations for Digoxin Use

Certain groups of patients may need special consideration when taking digoxin. Who are these groups and what precautions should be taken?

• Children: May be more sensitive to digoxin’s effects
• Older adults: May require dose adjustments due to age-related changes in kidney function
• Patients with kidney disease: May need lower doses or more frequent monitoring
• Individuals with hypothyroidism: May be more susceptible to digoxin’s effects

For these groups, healthcare providers may recommend more frequent monitoring, dose adjustments, or alternative treatments. It’s crucial for patients in these categories to communicate openly with their healthcare team about any concerns or side effects.

Monitoring and Managing Digoxin Therapy

Effective management of digoxin therapy involves regular monitoring and open communication with healthcare providers. What steps can patients take to ensure safe and effective treatment?

• Attend all scheduled follow-up appointments
• Undergo regular blood tests to check digoxin levels
• Report any new symptoms or side effects promptly
• Maintain a consistent diet, as changes in potassium intake can affect digoxin’s action
• Keep a list of all medications, including over-the-counter drugs and supplements

Regular monitoring allows healthcare providers to adjust the digoxin dose as needed, minimizing the risk of side effects while maximizing the medication’s benefits.

Drug Interactions and Precautions

Digoxin can interact with various medications and substances, potentially altering its effectiveness or increasing the risk of side effects. What should patients be aware of regarding drug interactions?

• Certain antibiotics can increase digoxin levels in the blood
• Some diuretics may affect potassium levels, impacting digoxin’s action
• Calcium channel blockers can increase digoxin concentration
• Herbal supplements like St. John’s Wort can interfere with digoxin metabolism

Patients should always inform their healthcare providers about all medications and supplements they’re taking. This includes over-the-counter drugs, vitamins, and herbal remedies. Healthcare providers can then assess potential interactions and adjust treatment plans accordingly.

Lifestyle Considerations

Beyond medication interactions, certain lifestyle factors can impact digoxin therapy. What lifestyle considerations should patients keep in mind?

• Maintain a consistent diet, especially regarding potassium-rich foods
• Avoid excessive alcohol consumption, which can affect digoxin levels
• Stay hydrated, but consult with a healthcare provider about appropriate fluid intake
• Exercise regularly as recommended by a healthcare provider

By being mindful of these factors, patients can help ensure the effectiveness of their digoxin therapy while minimizing the risk of side effects.

Reporting Side Effects and Seeking Support

Effective management of digoxin therapy involves not only being aware of potential side effects but also knowing how to report them and seek support when needed. What resources are available for patients taking digoxin?

• The Yellow Card safety scheme for reporting suspected side effects
• Patient support groups for individuals with heart conditions
• Pharmacist consultations for medication-related questions
• Regular check-ins with healthcare providers

Patients should feel empowered to communicate openly with their healthcare team about any concerns or questions regarding their digoxin therapy. This open dialogue can lead to better management of the medication and improved overall health outcomes.

The Importance of Patient Education

Understanding digoxin, its effects, and potential side effects is crucial for patients. How can patients become more informed about their medication?

• Read medication guides and package inserts carefully
• Ask healthcare providers questions during appointments
• Participate in patient education programs if available
• Use reputable online resources for additional information

By taking an active role in their treatment, patients can better manage their digoxin therapy and work effectively with their healthcare team to achieve optimal results.

In conclusion, while digoxin is a valuable medication for managing various heart conditions, it’s essential for patients to be aware of potential side effects and how to manage them. By understanding the risks, recognizing warning signs, and maintaining open communication with healthcare providers, patients can safely and effectively benefit from digoxin therapy. Remember, the key to successful treatment lies in balancing the medication’s benefits with careful management of any side effects that may occur.

Side effects of digoxin – NHS

Like all medicines, digoxin can cause side effects.

Some people are more sensitive to the effects of digoxin than others. These include children, older people, and people with kidney disease or an underactive thyroid (hypothyroidism).

Digoxin is safe to take as long as the benefits of taking it are greater than the risks. Your doctor will help you decide this.

Common side effects

These common side effects of digoxin happen in more than 1 in 100 people. There are things you can do to help cope with them:

Feeling dizzy

If digoxin makes you feel dizzy, lie down so that you do not faint, then sit until you feel better. Do not drive, ride a bike or use tools or machines until you feel better.

Feeling or being sick (nausea or vomiting)

Stick to simple meals and do not eat rich or spicy food. Drink plenty of fluids, such as water or squash, to avoid dehydration. If you’re being sick, take small, regular sips of water. If you have heart failure you may need to be careful about how much you drink – ask your doctor for advice.

If you take contraceptive pills and you’re being sick your contraception may not protect you from pregnancy. Check the pill packet for advice.

Diarrhoea

Drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. If you have heart failure you may need to be careful about how much you drink – ask your doctor for advice.

Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

If you take contraceptive pills and you have severe diarrhoea for more than 24 hours your contraception may not protect you from pregnancy. Check the pill packet for advice.

Changes in your vision (including blurred vision and not being able to look at bright light)

Do not drive, ride a bike or use tools or machinery until these symptoms stop.

Skin rashes

Ask a pharmacist or doctor if they can recommend something to help.

Talk to your doctor or pharmacist if the advice on how to cope does not help and these side effects bother you or last longer than a few days.

Important

Tell your doctor if you have more than 2 of the common side effects – it means you could have too much digoxin in your blood.

Serious side effects

It happens rarely, but some people have serious side effects after taking digoxin.

Tell your doctor or contact 111 straight away if you have more than 2 of the common side effects – it means you could have too much digoxin in your blood.

Go to 111.nhs.uk or call 111.

Immediate action required: Call 999 or go to A&E now if:

• you have a fast heart rate (palpitations), shortness of breath, feel dizzy or feel light-headed

Serious allergic reaction

It’s possible to have a serious allergic reaction (anaphylaxis) to digoxin.

Immediate action required: Call 999 or go to A&E now if:

• you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
• you’re wheezing
• you get tightness in the chest or throat
• you have trouble breathing or talking
• your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

Other side effects

These are not all the side effects of digoxin. For a full list see the leaflet inside your medicines packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

Page last reviewed: 22 March 2023

Next review due: 22 March 2026

Side Effects, Warning, Uses, and More

Highlights for digoxin

1. Digoxin oral tablet is available as both a generic and brand-name drug. Brand name: Lanoxin.
2. Digoxin is also available as an oral solution.
3. Digoxin oral tablet is used to treat atrial fibrillation, mild to moderate heart failure in adults, and heart failure in children.

Digoxin is a prescription drug. It comes as an oral tablet and an oral solution.

Digoxin oral tablet is available as the brand-name drug Lanoxin. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, the brand-name drug and the generic version may be available in different forms and strengths.

Why it’s used

Digoxin is used to treat atrial fibrillation and heart failure.

How it works

Digoxin belongs to a class of drugs called antiarrhythmics.

It works by slowing your heart rate down and improving the way your ventricles are filled with blood. Your ventricles are two of the four chambers of your heart.

Digoxin oral tablet does not cause drowsiness. However, it can cause other side effects.

More common side effects

The more common side effects that can occur with digoxin include:

• diarrhea
• dizziness
• headache

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Allergic reactions. Symptoms can include:
  • skin rash
  • hives
  • itching
  • swelling of your face, lips, or tongue
  • trouble breathing
• Changes in vision. Symptoms can include:
  • blurred vision
  • vision with a yellow-green tint
• Mental changes. Symptoms can include:
  • inability to think clearly
  • anxiety
  • depression
  • hallucinations
• Neurological problems. Symptoms can include:
  • confusion
  • changes in behavior, such as hallucinations and psychotic episodes
  • feeling lightheaded or faint
  • headache
• Gastrointestinal problems. Symptoms can include:
  • nausea or vomiting
  • persistent diarrhea
  • severe stomach pain
• Fast, irregular heart rate
• Unexplained bleeding or bruising
• Unusual weakness or tiredness

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Digoxin oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with digoxin are listed below.

Heart failure drug

Taking digoxin with ivabradine, a heart failure drug, can increase your risk of side effects. These side effects include bradycardia (a slowed heart rhythm). If you need to take these drugs together, your doctor may monitor you closely.

Heart rhythm drugs

Taking digoxin with certain heart rhythm drugs may increase the levels of digoxin in your body and increase your risk of side effects, including heart problems. If you need to take these drugs with digoxin, your doctor may monitor you closely.

Examples of these drugs include:

• amiodarone
• quinidine
• dofetilide
• dronedarone
• propafenone
• sotalol

HIV medications

Taking digoxin with certain HIV drugs can increase the level of digoxin in your body. This could cause increased side effects. If you need to take these drugs with digoxin, your doctor may lower your dose of digoxin before you start taking these medications.

Examples of these drugs include:

• ritonavir
• saquinavir
• lopinavir/ritonavir

Blood pressure drugs

Taking digoxin with certain blood pressure medications can increase the level of digoxin in your body. If you need to take these drugs with digoxin, your doctor will likely reduce your digoxin dosage first. They may also monitor your digoxin levels during your treatment with these drugs.

Examples of these drugs include:

• captopril
• carvedilol
• diltiazem
• verapamil
• nifedipine
• spironolactone
• telmisartan

Antibiotics

Taking digoxin with certain antibiotics can increase digoxin levels in your body. If you need to take these drugs with digoxin, your doctor will likely reduce your digoxin dosage first. They may also monitor your digoxin levels during your treatment with these drugs.

Examples of these drugs include:

• azithromycin
• clarithromycin
• erythromycin
• gentamicin
• trimethoprim
• tetracycline

Immune-suppressing drug

Taking digoxin with cyclosporine can increase digoxin levels in your body. If you need to take cyclosporine with digoxin, your doctor will likely reduce your digoxin dosage first. They may also monitor your digoxin levels during your treatment with cyclosporine.

Cholesterol-lowering drug

Taking digoxin with atorvastatin can increase digoxin levels in your body. If you need to take atorvastatin with digoxin, your doctor will likely reduce your digoxin dosage first. They may also monitor your digoxin levels during your treatment with atorvastatin.

Antifungal drugs

Taking digoxin with certain antifungal drugs can increase digoxin levels in your body. If you need to take these drugs with digoxin, your doctor will likely reduce your digoxin dosage first. They may also monitor your digoxin levels during your treatment with these drugs.

Examples of these drugs include:

• itraconazole
• ketoconazole

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Taking digoxin with NSAIDs can increase digoxin levels in your body. If you need to take these drugs with digoxin, your doctor will likely reduce your digoxin dosage first. They may also monitor your digoxin levels during your treatment with NSAIDs.

Examples of NSAIDs include:

• indomethacin
• ibuprofen
• diclofenac

Antidepressant

Taking digoxin with nefazodone can increase digoxin levels in your body. If you need to take this drug with digoxin, your doctor will likely reduce your digoxin dosage first. They may also monitor your digoxin levels during your treatment with nefazodone.

Antimalarial drug

Taking digoxin with quinine can increase digoxin levels in your body. If you need to take this drug with digoxin, your doctor will likely reduce your digoxin dosage first. They may also monitor your digoxin levels during your treatment with quinine.

Chest pain drug

Taking digoxin with ranolazine can increase digoxin levels in your body. If you need to take this drug with digoxin, your doctor will likely reduce your digoxin dosage first. They may also monitor your digoxin levels during your treatment with ranolazine.

Stimulant drugs

Taking digoxin with drugs called stimulants can lead to an irregular heart rhythm. Examples of these drugs include:

• epinephrine
• norepinephrine
• phenylephrine

Neuromuscular blocker

Taking digoxin with succinylcholine can lead to an irregular heart rhythm.

Drugs used to treat low sodium levels

Taking digoxin with certain drugs used to increase sodium levels in your blood may increase digoxin levels in your body. If you need to take these drugs with digoxin, your doctor will likely reduce your digoxin dosage first. They may also monitor your digoxin levels during your treatment with these drugs.

These medications are:

• tolvaptan
• conivaptan

Cancer drug

Taking digoxin with lapatinib can increase digoxin levels in your body. If you need to take this drug with digoxin, your doctor may need to adjust your digoxin dosage.

Proton pump inhibitors

Taking digoxin with proton pump inhibitors (PPIs) can increase the levels of digoxin in your body. If you need to take these drugs with digoxin, your doctor may need to adjust your digoxin dosage.

Examples of PPIs include:

• rabeprazole
• esomeprazole
• lansoprazole
• omeprazole

Antiplatelet drug

Taking digoxin with ticagrelor can increase digoxin levels in your body. If you need to take this drug with digoxin, your doctor may need to adjust your digoxin dosage.

Overactive bladder drug

Taking digoxin with mirabegron can increase digoxin levels in your body. If you need to take this drug with digoxin, your doctor will likely reduce your digoxin dosage first. They may also monitor your digoxin levels during your treatment with mirabegron.

Propantheline

Taking digoxin with propantheline can increase digoxin levels in your body. If you need to take this drug with digoxin, your doctor will likely reduce your digoxin dosage first. They may also monitor your digoxin levels during your treatment with propantheline.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This dosage information is for digoxin oral tablet. All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how you react to the first dose

Forms and strengths

Generic: Digoxin

• Form: oral tablet
• Strengths: 125 mcg and 250 mcg

Brand: Lanoxin

• Form: oral tablet
• Strengths: 62.5 mcg, 125 mcg, and 250 mcg

Dosage for mild to moderate heart failure in adults

Adult dosage (ages 18 years and older)

• Loading (starting) dose:
  • The total dose is 10–15 mcg per kilogram (kg) of body weight divided and taken 3 times per day.
  • You should take half of the loading dose first, and then take half of the remaining dose 6 to 8 hours later. Take the rest of the dose 6 to 8 hours after that.
• Maintenance dosage:
  • The maintenance dosage is individualized. It’s based on your weight, age, kidney function, current medical conditions, and other medications you may be taking. Your doctor will determine your maintenance dosage.
  • The maintenance dosage is taken once per day.

Dosage for atrial fibrillation in adults

Adult dosage (ages 18 years and older)

• Loading (starting) dose:
  • The total dose is 10–15 mcg per kilogram (kg) of body weight divided and taken 3 times per day.
  • You should take half of the loading dose first, and then take half of the remaining dose 6 to 8 hours later. Take the rest of the dose 6 to 8 hours after that.
• Maintenance dosage:
  • The maintenance dosage is individualized. It’s based on your weight, age, kidney function, current medical conditions, and other medications you may be taking. Your doctor will determine your maintenance dosage.
  • The maintenance dosage is taken once per day.

Dosage for heart failure in children

Child dosage (ages 11–17 years)

• Loading (starting) dose:
  • The total dose is 10–15 mcg per kilogram (kg) of body weight divided and taken 3 times per day.
  • Your child should take half of the loading dose first, and then take half of the remaining dose 6 to 8 hours later. They should take the rest of the dose 6 to 8 hours after that.
• Maintenance dosage:
  • The maintenance dosage is individualized. It’s based on your child’s weight, age, kidney function, current medical conditions, and other medications they may be taking. Your child’s doctor will determine their maintenance dosage.
  • The maintenance dosage is taken once per day.

Child dosage (ages 5–10 years)

• Loading (starting) dose:
  • The total dose is 20–45 mcg per kilogram (kg) of body weight divided and taken 3 times per day.
  • Your child should take half of the loading dose first, and then take half of the remaining dose 6 to 8 hours later. They should take the rest of the dose 6 to 8 hours after that.
• Maintenance dosage:
  • The maintenance dosage is individualized. It’s based on your child’s weight, age, kidney function, current medical conditions, and other medications they may be taking. Your child’s doctor will determine their maintenance dosage.
  • The maintenance dosage is taken once per day.

Child dosage (ages 0–4 years)

A safe and effective dosage hasn’t been established for this age group.

Special dosage considerations

• For people with kidney disease: Digoxin is cleared from your body by your kidneys. If you have kidney disease, your dose of digoxin will be lower.
• For people with hypothyroidism: You might be more sensitive to digoxin. Because of this, your dosage of digoxin may need to be reduced.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Digoxin oral tablet comes with several warnings.

High dosage warning

Certain symptoms may indicate that your dosage of digoxin is too high. Call your doctor if you experience:

• nausea
• vomiting
• persistent diarrhea
• confusion
• weakness
• loss of appetite
• abnormal heart rhythm
• problems with vision

Risk of overdose in children

If your child is taking digoxin, make sure you’re aware of the symptoms of overdose in children. These include:

• weight loss
• failure to thrive
• stomach pain
• drowsiness
• behavioral changes

Allergy warning

This drug may cause a severe allergic reaction. Symptoms may include:

• skin rash
• hives
• itching
• swelling of your face, lips, or tongue
• trouble breathing

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Warnings for people with certain health conditions

For people with ventricular fibrillation: Digoxin can’t be used if you have ventricular fibrillation. It may make your ventricular fibrillation worse.

For people with Wolff-Parkinson-White syndrome: If you have Wolff-Parkinson-White syndrome, you’re at a higher risk for an abnormal heart rhythm. Digoxin may increase your risk even further.

For people with sinus node disease and AV block: Digoxin can cause severe low heart rate and complete heart block if you have sinus node disease or atrioventricular (AV) block. If you have sinus node disease or AV block, you should get a pacemaker before starting digoxin.

For people with preserved left ventricular systolic function: If you have this type of heart failure, you should not use digoxin. It may increase your risk of side effects, such as chest pain and shortness of breath.

For people with a risk of ventricular arrhythmias during electrical cardioversion: If you’re going to receive electrical cardioversion, your dosage of digoxin may be reduced, or your treatment with the drug may be stopped 1 to 2 days before your procedure. This is done to prevent heart rhythm problems.

For people with a heart attack: Digoxin isn’t recommended for people having a heart attack. Using this drug can restrict blood flow to the heart.

For people with myocarditis: You shouldn’t use digoxin if you have myocarditis. It can narrow your blood vessels and cause inflammation.

For people with kidney disease: Digoxin is cleared from your body by your kidneys. If your kidneys don’t work well, the drug may build up to dangerous levels. Your digoxin dosage should be decreased if you have kidney problems.

For people with hypothyroidism: You might be more sensitive to digoxin. Because of this, your dosage of digoxin may need to be reduced.

For people with electrolyte imbalances: If you have low potassium levels, digoxin may be more active in your body, increasing your risk of dangerous side effects.

• If you have low levels of magnesium, your heart may be more sensitive to changes in heart rhythm caused by digoxin.
• If you have low calcium levels, digoxin may not work as well.

Warnings for other groups

For pregnant women: Digoxin is a category C pregnancy drug. That means there haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. Digoxin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

For women who are breastfeeding: Studies have shown that digoxin passes through breast milk. It’s unknown if this causes any effects in a breastfeeding child. You and your doctor may need to decide if you’ll take digoxin or breastfeed.

For seniors: Seniors may need smaller doses of digoxin and may be monitored more closely. Adults over 65 years old are more likely to have kidney problems, which may lead to greater drug side effects.

For children: This drug hasn’t been established as safe oreffective for use in people under the age of 18 years. However, the drug may still be used to treat heart failure in children.

Digoxin oral tablet is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all: Your condition may get worse, which can lead to hospitalization or even death.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug in adults and children can include:

• nausea
• vomiting
• loss of appetite
• fatigue
• irregular heart rate
• dizziness
• vision problems

Other signs of overdose in children and infants include:

• failure to thrive
• behavioral changes, such as hallucinations and psychotic episodes
• weight loss
• stomach pain
• drowsiness

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 1-800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell the drug is working: Your heart rate should return to normal or your symptoms should get better.

Keep these considerations in mind if your doctor prescribes digoxin oral tablets for you.

General

• You don’t have to take digoxin with food.
• You can crush or cut a digoxin tablet.

Storage

• Store digoxin tablets at room temperature between 68°F and 77°F (20°C and 25°C). Store it in its original container to protect it from light.
• Keep the container tightly closed.
• Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They won’t damage your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

During your treatment with digoxin, your doctor will monitor your:

• electrolyte levels
• kidney function
• levels of digoxin (to make sure they’re still safe for you)
• blood pressure and heart rate (you should also check your blood pressure and heart rate each day)

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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European Society of Cardiology (ESC) guidelines for the diagnosis and treatment of heart failure

What patients need to know

This European Society of Cardiology (ESC) patient guide is a summary of the most current evidence-based recommendations for the diagnosis and treatment of heart failure.

In particular, it is designed to help patients understand:

• what are the main types of heart failure;
• what medicines are used to treat heart failure;
• which devices can be used;
• why full rehabilitation is important;
• how important is treatment by medical specialists of different profiles;
• how important it is to take care of yourself and control your condition.

To learn more

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ANIMATED JOURNEY OF HEART FAILURE

A series of simple yet entertaining animated videos explaining heart failure and its treatment

These videos explain how a healthy heart works, what happens in heart failure and how various treatments can help improve your health

How a healthy heart works

What happens in heart failure

How the heart and other organs adapt to heart failure

How heart failure causes fluid retention

How myocardial infarction can cause heart failure

How valve dysfunction causes heart failure

How vasodilators work in heart failure

How diuretics work in heart failure

How the auxiliary circulatory systems work in cardiac

VIDEOS OF PATIENTS AND STAFF

In this section you can see, hear or read interviews with other heart failure patients or caregivers

Fitness patient

Implantable cardioverter-defibrillator (ICD) patient

BLI as preparation for transplantation

Changing lifestyle and staying optimistic

Living with heart failure devices

Difficulty in making a diagnosis

Life with an artificial left ventricle (LVV)

VISIT OUR FACEBOOK PAGE

And share your opinions and experiences with other patients, their families and carers.

https://www.facebook.com/heartfailurematters

heartfailurematters.org — website of the European Society of Cardiology

The website heartfailurematters.org was created under the direction of the Association of Heart Failure Specialists of the European Society of Cardiology (ESC). ESC is a world leader in the discovery and dissemination of advanced methods of cardiovascular medicine. Our members and decision makers are medical professionals who volunteer their time and knowledge as cardiologists in Europe and beyond.

Botox myths debunked – 10 most common misconceptions

Botulinum toxin, once called “the most toxic poison on the planet”, has recently found its way into the treatment of many diseases. In the UK and the US, the drug is marketed under the brand names Botox and Dysport. In fact, Botox is the name of Allergan’s drug, which has become a household name.

It is currently used in the treatment of incontinence, stuttering, prostatitis and has recently been claimed to treat depression. Despite numerous studies, Botox is still surrounded by many myths. The same questions keep coming up: is it toxic? Will the face become lifeless? Will facial expressions suffer?

Myth 1: Botox injections are highly toxic

Almost any medicine is a solution of poison. For heart attacks, hospitals use digoxin, atropine, lignocaine, or epinephrine to save lives. All these are chemicals of plant, animal or microbiological origin. Digoxin, an extract from the foxglove plant, can stop the heart if the dosage is exceeded. When diluted, it restores the normal beat rhythm. Other medicines, such as atropine, an extract of nightshade, block nerve endings, restoring the rhythm of the heart. In ancient Rome, atropine solution was instilled into the eyes to dilate the pupils and thereby attract the attention of admirers. Same with Botox is a solution of botulinum toxin that can cause food poisoning. The safety of Botox, among other things, is ensured by selective injection into certain muscles, which limits its distribution under the skin. Infants with cerebral palsy or muscle spasms are given much higher doses as daily therapy. Many doctors will agree that aspirin and antibiotics are much more dangerous than Botox. However, as is the case with many drugs, Botox must be administered by an experienced specialist, otherwise anaphylaxis is possible.

Myth 2: A patient can become addicted to Botox

This myth is based on a recent study of patients from 81 clinics. As a result, it was found that more than 40% of patients who regularly resort to Botox procedures do it impulsively. Once resorting to wrinkle injections, in 40% of cases they will do it again. Those who underwent 5 or more procedures were more addicted. However, the issue is highly controversial. Can a twice-yearly procedure be considered addictive? Moreover, if one resorts to Botox more often, the body will begin to produce antibodies. This is akin to if an alcoholic were to drink wine, which after the second sip turned into water. It is unlikely that this dependence will last long. In addition, the very concept of addiction implies the use of the drug with full awareness of its detrimental effect on the body. However, there is no evidence of the existence of side effects of Botox, on the contrary, it promotes the regeneration of nerve tissues. In fact, such pseudoscientific conclusions only confuse the audience, providing a brief moment of glory to the charlatan doctors whose claims the medical profession has had to debunk for years.

Myth 3: Botox injections are painful

Conversely, Botox injections usually do not cause pain. The needles used are very thin, the same as those used daily by diabetics. Patients usually compare the sensations during Botox injections to an insect bite. However, some people apply an anesthetic cream to the face 15 minutes before the procedure, this completely eliminates possible pain. After the injection, pain is generally impossible: Botox itself acts as an anesthetic.

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Myth 4: Botox causes headaches

On the contrary, while causing headaches in 2-3% of patients, Botox completely relieves everyone else. Moreover, it is used to treat migraine , for this the drug is injected at key points, individually determined for each patient. The duration of the effect of such therapy is 10-13 weeks, but it is not recommended to repeat it more often than after 3-4 months. A study was conducted in which 10 women with severe and prolonged migraines were injected with Botox. After 2 weeks 9of them no longer experienced pain. The result lasted 4-6 months. The same effect is achieved in the clinical setting.

Myth 5: Botox distorts facial expressions

This is one of the most popular misconceptions. Many people forget that the result of the procedure depends on the skills of the specialist conducting it, and not on the drug itself. This means that the ability of the eyebrows to rise and fall, as well as the smoothing of wrinkles, depends on two factors – the amount and place of injection of the drug.

Accordingly, the facial expression may be disturbed if the dosage is exceeded, or Botox is entered incorrectly. If your new washing machine flooded your neighbors, you’ll blame the plumber, not the sewer service. And one more thing – if you still want to look 5 years younger, contact an experienced certified specialist, and not the numerous charlatans that have flooded the market.

Myth 6: Botox injections will cure depression

This misconception was born from a 2006 clinical study on people suffering0123 depression patients. The doctors who conducted the experiment argued that by depriving a person of the opportunity to frown, it is possible to stop the neurological reactions of the brain that cause a depressive state. However, if you look closely at the details of the study, you can see that it was carried out on a very small number of patients, without the participation of psychiatrists, and included self-assessments of the subjects. Many called this experiment anecdotal. However, the patent for the drug treatment of depression with Botox is still pending. However, even if it is obtained, it should not be considered proof that Botox can be used to treat depression.

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Myth 7: Botox injections cause new wrinkles

This statement was born in 2002 when Professor David Becker in New York, he suggested that patients with paralysis of the muscles of the face perform a series of exercises. He noted the appearance of deep wrinkles and the appearance of new ones after the introduction of Botox in the frontal part of the face. His suggestion that paralysis of some muscles can be compensated for by others was not supported by Allergan (the manufacturer of Botox), which immediately refuted this claim. Becker soon retracted his statements. In fact, a similar effect may be present, but in such a meager form that patients do not even notice it.

Myth 8: Botox injections should be banned for people under 40

It’s hard to say where this statement comes from. Perhaps the reason for this was the older generation, less influenced by the press, which considers Botox injections to be an extremely important and intimate event. In fact, the minimum age for Botox injections in the US has already dropped to 19.years, and in Australia they are going to legally allow its use until the age of eighteen. Why did such a difference in perception arise among different generations of ? It is easier for young people to start dealing with the problem at an early stage and not to allow the appearance of wrinkles at all. Perhaps if you start earlier, in the future there will be much less worries.

Myth 9: Frequent use of Botox loses its effectiveness

There is evidence that about 5% of patients can develop antibodies that ultimately reduce the effectiveness of injections to a minimum. The likelihood of this phenomenon may increase with large doses of the drug or repeated injections with a break of less than 4 weeks. However, new forms of the drug with a reduced protein content are now appearing on the market. This will probably solve the problem of low efficiency of injections 9 Poor storage of toxins Editor’s note

Myth 10: Botox injections are a risk of unexpected side effects : side effects are extremely rare, are mild and short term. Usually this is nausea, lethargy, general malaise, cold symptoms or a rash.

Needle sticks may cause bruising, pain, redness, headache and localized numbness. The most common side effect is usually weakening of the nerves around the eyes.