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Digoxin Dosages: Your GoodRx Guide

Key takeaways:

  • Digoxin (Lanoxin) is FDA approved to treat atrial fibrillation in adults. It’s also approved to treat heart failure in both adults and children. Digoxin is usually taken by mouth once or twice daily, but the specific amount of medicine you’ll take will vary based on factors such as your age, body weight, and the health condition being treated.

  • Your healthcare professional (HCP) should routinely monitor your blood digoxin levels to make sure you’re taking a safe dose. Older adults, people with low kidney function, and people with a low body weight may also need an adjustment in their starting dose. 

  • Digoxin is available as a lower-cost generic. GoodRx can help you save over 70% off the average retail price at certain pharmacies.

Access savings on related medications

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GoodRx Health

Heart failure and atrial fibrillation are two chronic health conditions related to the heart. Although they’re different from each other, there’s one medication that can treat both — digoxin (Lanoxin). It treats these conditions by strengthening and regulating the heart’s contractions.

Digoxin has been around for many decades. But newer medications have begun to take its place. A main reason for this is that digoxin often has heart- and gastrointestinal (GI)-related side effects. There is a risk for toxicity with high levels of digoxin in the body too. This can happen if you take a dose that’s higher than recommended or that your body can’t tolerate.

If you do take digoxin, your healthcare professional (HCP) should order routine blood work to keep an eye on your digoxin levels. Taking the right dose is the best way to keep yourself safe. This dosing guide provides general recommendations about digoxin dosages for adults and children. But it can vary from person to person, so make sure to talk to your HCP about the right dose for you.

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What’s the typical digoxin dosage for adults?

Digoxin can treat mild-to-moderate heart failure in adults. It can also manage resting heart rate issues in adults with atrial fibrillation. The recommended dose of digoxin depends which condition you’re taking it for and factors such as age, body weight, and kidney function.

Digoxin is available as a tablet, oral liquid, and intravenous (IV) injection. The tablets come in three different doses: 62.5 mcg, 125 mcg, and 250 mcg. The oral liquid comes in a concentration of 50 mcg/mL. And the IV injection is usually only given in a hospital or medical office. Of these, adults most commonly take digoxin tablets. 

Depending on what you’re taking digoxin for, you may need a loading dose to start. A loading dose is a higher initial dose that quickly raises digoxin levels in your body. After this initial dose, it’s recommended to take a lower, daily maintenance dose over time. But a loading dose is not always needed; some people start with a maintenance dose.

Here’s a summary of recommended oral digoxin dosages for adults:

Use

Loading dose

Maintenance dosage

Atrial fibrillation 

500-750 mcg once*
(if a loading dose is recommended by an HCP)*

62.5-250 mcg once daily*, but can adjust to maintain digoxin levels between 0.8-1.2 ng/mL*

Heart failure

Not recommended

125-250 mcg once daily*, but can adjust to maintain digoxin levels between 0.5-0.9 ng/mL

*Your prescriber may prescribe a different weight-based dose from what’s described here. Digoxin dosages are highly variable from person to person.

GoodRx icon
  • Shifting your sight: One of digoxin’s potential side effects is a change to your eye health. Here’s what to know about digoxin’s vision effects.

  • A watchful eye: Digoxin is known to cause some serious side effects that could lead to toxicity. This is why you and your prescriber will want to routinely monitor digoxin levels in your blood.

  • Interactions with other drugs: Several medications can affect your digoxin levels. See which ones do and how to manage them.

What’s the typical digoxin dosage for children?

Digoxin can also be given to children with heart failure since it boosts the heart’s ability to contract. Children ages 5 years and older can take the tablets, while the oral liquid can be given to children of any age — even premature infants.

A loading dose isn’t always recommended when treating heart failure in children. Children will generally take a maintenance dose based on their age and body weight. The goal is to maintain digoxin levels between 0.8 and 2 ng/mL. Compared to the tablets, the oral liquid is easier to dose based on body weight.

Age

Digoxin dosage

Premature infant

5 mcg/kg per day (dose split up to be given twice daily)

Full-term infant

8-10 mcg/kg per day (dose split up to be given twice daily)

Less than 2 years old

10-12 mcg/kg per day (dose split up to be given twice daily)

2-5 years old

8-10 mcg/kg per day (dose split up to be given twice daily)

5-10 years old

5-10 mcg/kg per day (dose split up to be given twice daily)

10-18 years old

125 mcg-500 mcg once daily

No need to grab your calculator; your child's prescriber will calculate this dose for you. But be sure to follow their directions closely to ensure you give your child the correct dose. They can also tell you if your child will need a loading dose.

Are there any dosage adjustments for medical conditions?

Yes. Your initial digoxin dose should be adjusted based on your age, body weight, and kidney function. Your HCP will make these dose adjustments for you.

Initial dosages should be lower — such as 125 mcg daily or every other day — for people older than 70 years old. This is also the case for adults with lower kidney function or a low body weight.

Children with a low body weight or low kidney function should also start with lower doses of digoxin. The dosage may be as low as 62.5 mcg daily. After that, an HCP can check digoxin blood levels to determine if the dose needs to be adjusted.

Keep in mind: Older adults, people with a low body weight, and people with kidney problems have higher risk of developing digoxin toxicity. That’s why it’s important to start with a lower dose than usual.

What happens if you miss a dose of digoxin?

It’s important to take digoxin regularly as prescribed. But we get it — missed doses happen as life gets busy. If you miss a dose, take it as soon as you remember. But if it’s almost time for your next dose, skip the dose you missed. Take your next dose at the usual time. Taking two doses of digoxin too close together can make your digoxin levels too high.

It’s important to be honest and tell your HCP if you find yourself missing doses often. They can recheck your blood digoxin level to make sure that you’re still within a normal, safe range.

What should you do if you take too much digoxin?

Side effects can happen with any amount of digoxin. But if you take too much, there is a risk of developing digoxin toxicity. This is more serious than experiencing standard side effects, such as changes in heart rate, nausea, or vomiting.

Digoxin has a narrow therapeutic index. This means that even small changes in the amount of medication in your body could lead to serious problems. The medication can become toxic if the level rises above 2 ng/mL. These are some symptoms of digoxin toxicity:

  • Nausea and vomiting

  • Persistent diarrhea

  • Yellow or green-tinted vision

  • Fluttering heart rate

  • Trouble breathing

If you experience any of these symptoms while taking digoxin, get medical care right away. An HCP can check your blood digoxin levels and even administer an antidote medication to reverse the effects, if needed.

How to save on digoxin

There are many ways to save on digoxin, which is available as both a brand-name and generic medication. GoodRx can help you save over 70% off the average retail price of the generic version. Generic digoxin’s price at certain pharmacies is as low as $24.00 with a free GoodRx discount.

The bottom line

Digoxin (Lanoxin) is used to treat adults with atrial fibrillation. It can also treat adults and children with heart failure. Depending on what you’re taking it for, the maintenance dosage ranges from 62.5 mcg to 250 mcg once daily in adults. But there’s a good chance you’ll receive a slightly different dose based on your body weight instead. Some adults may also need a loading dose to quickly raise digoxin levels. In children, the dose varies by age and body weight. You will likely have your blood digoxin checked routinely to make sure it stays at a safe level.

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Why trust our experts?

Hindu Rao, PharmD, APh, BCACP
Hindu Rao, PharmD, APh, BCACP is a clinical assistant professor of pharmacy practice at Chapman University School of Pharmacy and a clinical pharmacist at Providence Medical Foundation. She specializes in chronic disease management and has her board certification in ambulatory care.
Lauren Freels, PharmD Candidate
During her schooling, Lauren has gained experience in a multitude of fields within pharmacy, such as community, hospital, and nontraditional pathways. All of her experiences have driven her passion for public health and being able to have a positive impact in the healthcare field.
Alyssa Billingsley, PharmD
Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

References

Bryant Ranch Prepack. (2024). Digoxin- digoxin tablet [package insert].

Cummings, E. D., et al. (2023). Digoxin toxicity. StatPearls. 

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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