A GoodRx Guide to Narrow Therapeutic Index Drugs
With narrow therapeutic index drugs, even small changes in dosage can be dangerous. Learn more about how to protect your safety if you’re taking one of these medications.
digoxin
Used for Atrial Fibrillation, Heart Failure
Used for Atrial Fibrillation, Heart Failure
Digoxin (Lanoxin) is an antiarrhythmic medication used to treat heart failure and atrial fibrillation (AFib) in adults and children. It's taken by mouth typically once or twice daily, but the specific dosage will depend on several things like your age, weight, and blood digoxin levels. Side effects include changes in vision, stomach upset, and dizziness. There's also a risk of digoxin toxicity, which means having too much of the medication in your body. This can lead to severe side effects such as vision changes and changes to the heart rhythm.
What is Digoxin (Lanoxin)?
What is Digoxin (Lanoxin) used for?
- Heart failure in adults and children ages 5 years and older
- Atrial fibrillation (AFib) in adults
How Digoxin (Lanoxin) works
Digoxin (Lanoxin) is a cardiac glycoside. It works by blocking a protein in your heart, which in turn causes your heart to pump more strongly with each beat. This helps people with heart failure get more blood and oxygen to the rest of their body.
Digoxin (Lanoxin) also slows down the electrical activity in the heart, which helps people with atrial fibrillation have better control on their heart rate.
Drug facts
| Common Brands | Lanoxin |
|---|---|
| Drug Class | Antiarrhythmic |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
Side effects of Digoxin (Lanoxin)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Changes in heart rate
- Nausea
- Vomiting
- Diarrhea
- Reduced appetite
Less Common Side Effects
- Headache
- Weakness
- Dizziness
- Confusion
- Rash
- Enlarged male breasts
Digoxin (Lanoxin) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Abnormal heart rhythm: chest pain, chest discomfort, palpitations, shortness of breath, fatigue, weakness, sweating
- Digoxin toxicity: nausea, vomiting, loss of appetite, changes in vision, confusion, palpitations, or abnormally slow heart rate
More on Digoxin (Lanoxin) side effects
The following Digoxin (Lanoxin) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Digoxin toxicity—confusion, loss of appetite, nausea, vomiting, diarrhea, change in vision such as blurry or yellow vision, fatigue, fast or irregular heartbeat
- Slow heartbeat—dizziness, feeling faint or lightheaded, confusion, trouble breathing, unusual weakness or fatigue
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Dizziness
- Stomach pain
- Unexpected breast tissue growth
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Pros and cons of Digoxin (Lanoxin)
Pros
- Can be used in young children to treat heart failure
- Doesn't affect blood pressure much
- Available as a lower-cost generic
Cons
- Can cause serious and potentially life-threatening side effects if medication levels in the blood are too high
- Need to get regular blood tests during treatment
- Interacts with many medications
Pharmacist tips for Digoxin (Lanoxin)
- Digoxin (Lanoxin) interacts with many medications. Some medications can raise or lower the levels of digoxin (Lanoxin) in the blood. Always let your provider and pharmacist know what medications you take, including herbal supplements and over-the-counter medications.
- Mark your calendar to get any blood work done when you take digoxin (Lanoxin). You'll need blood tests to check digoxin (Lanoxin) levels, how well your kidneys are working, and blood electrolytes.
- Digoxin (Lanoxin) can cause dizziness and vision changes including blurry vision, sensitivity to light, changes in how you see color, and seeing halos. Let your provider know if you start to experience these symptoms.
- If you have nausea, vomiting, diarrhea, confusion, weakness, or changes in vision that don't go away, you might be experiencing digoxin toxicity. It's recommended to get medical help right away so you can get your digoxin (Lanoxin) level checked and receive treatment if needed.
- Be sure to keep yourself well hydrated, especially during hot weather since dehydration can affect the kidneys and cause higher levels of digoxin (Lanoxin) in the body.
- Measure and record your blood pressure and heart rate at home and bring those measurements to your appointments. This will help your provider see how well the medication is working for you and if you're having side effects.
- If you're using the liquid form of digoxin (Lanoxin), only use the oral syringe that comes with the medication. Never use household spoons to measure your dose because it might not be accurate.
- Store the digoxin (Lanoxin) at room temperature and keep it in the original bottle it came from to protect it from light.
More on Digoxin (Lanoxin) tips
Risks and warnings for Digoxin (Lanoxin)
Digoxin (Lanoxin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Abnormal heart rhythm
- Risk factors: Wolff-Parkinson-White syndrome | History of abnormal heart rate or heart rhythm problem | Electrical cardioversion | Taking other medications that affect heart rate or rhythm
Digoxin (Lanoxin) can cause abnormal heart rhythms (e.g., ventricular fibrillation, abnormally slow heart rate, and heart block), especially in people with a history of heart rate or heart rhythm problems. Some of these rhythms can be life-threatening. Make sure your provider knows your full medical history before you start on digoxin (Lanoxin). Also, if you're undergoing electrical treatment for atrial fibrillation, let your provider know because you might need to stop taking digoxin (Lanoxin) 1 or 2 days beforehand. If you experience chest pain, chest discomfort, palpitations, shortness of breath, fatigue, weakness, sweating, seek medical attention right away.
Digoxin toxicity
- Risk factors: Low body weight | Older adults | Kidney problems | Abnormal levels of potassium, magnesium, or calcium | Taking other medications that raise levels of digoxin (Lanoxin)
Digoxin toxicity can happen if you have too much digoxin (Lanoxin) in your body. Your provider will check your kidney function and digoxin (Lanoxin) blood levels regularly during treatment to make sure that you continue taking the right dose. If you experience nausea, vomiting, loss of appetite, changes in vision, confusion, palpitations, or abnormally slow heart rate, seek medical attention right away.
Worsening heart conditions
- Risk factors: History of heart conditions (e.g., heart attack, myocarditis, cardiomyopathy, pericarditis, amyloid heart disease)
People with certain types of heart conditions should avoid digoxin (Lanoxin) due to the potential for worsening symptoms. Make sure to tell your provider about all of your health problems before starting digoxin (Lanoxin). They'll help you determine if the medication is right for you.
Less efficacy in people with low calcium levels
Digoxin (Lanoxin) won't work well if you have low calcium levels. If your calcium levels are low, your provider might suggest treatment to raise your calcium levels to a healthy level in order to get the full effect of digoxin (Lanoxin).
Different responses in people with thyroid and metabolism problems
People with underactive thyroid usually need less digoxin (Lanoxin). On the other hand, atrial fibrillation due to overactive thyroid or metabolism won't respond well to digoxin (Lanoxin). In these cases, it's more important to fix the underlying problem that's causing the fast heart rhythm.
Digoxin (Lanoxin) dosage
The average cost for 90 tablets of 125mcg of Digoxin (Lanoxin) is $24.00 with a free GoodRx coupon. This is 0.00% off the average retail price of $24.00.
Typical dosage for Digoxin (Lanoxin)
The dose will depend on many factors such as your body weight, kidney health, age, other medications you're taking, and the form of digoxin (Lanoxin) you're using (liquid or tablets).
Your provider will adjust your dose based on blood levels of digoxin (Lanoxin) and if you're having side effects.
- Ages 10 years and older: In general, the typical dose ranges from 3.4 mg/kg to 5.1 mg/kg, taken by mouth once daily.
- Ages less than 10 years:: In general, the typical maintenance dose ranges from 3.2 mg/kg to 6.4 mg/kg, taken by mouth twice daily.
Digoxin (Lanoxin) is also available as an injection that's used for people in the hospital.
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How much does Digoxin (Lanoxin) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Digoxin (Lanoxin) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Digoxin (Lanoxin) will not be safe for you to take.
- Ventricular fibrillation, a serious type of abnormal heart rhythm
What are alternatives to Digoxin (Lanoxin)?
There are a number of medications that your doctor can prescribe in place of Digoxin (Lanoxin). Compare a few possible alternatives below.
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Digoxin (Lanoxin) images
