digoxin
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.
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What are the side effects of Digoxin (Lanoxin)?
Common Side Effects
- Changes in heart rate
- Nausea
- Vomiting
- Diarrhea
- Reduced appetite
Other Side Effects
- Headache
- Weakness
- Dizziness
- Confusion
- Rash
- Enlarged male breasts
Serious Side Effects
- 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
Source: DailyMed
More on Digoxin (Lanoxin) side effects
The following 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
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
Frequently asked questions about Digoxin (Lanoxin)
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What are the 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 forms
Typical dosing 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?
Digoxin (Lanoxin) contraindications
Ventricular fibrillation, a serious type of abnormal heart rhythm
What are alternatives to Digoxin (Lanoxin)?
Heart failure in adults and children ages 5 years and older
Atrial fibrillation (AFib) in adults
Heart failure in people ages 1 year or older
Chest pain (angina)
Prevention and treatment of certain types of arrhythmias
What is the latest news about Digoxin (Lanoxin)?
Digoxin (Lanoxin) images
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References
Best studies we foundAmerican Heart Association. (2022). Ventricular fibrillation.
Amici Pharmaceuticals, LLC. (2023). Digoxin solution [package insert]. DailyMed.
Cummings, E. D., et al. (2023). Digoxin toxicity. StatPearls.
David, M. N. V., et al. (2023). Digoxin. StatPearls.
Erol, K., et al. (2001). Morning-evening administration time differences in digoxin kinetics in healthy young subjects. Chronobiology International.
Konstantinou, D. M., et al. (2016). Digoxin in heart failure with a reduced ejection fraction: A risk factor or a risk marker? Cardiology.
Oliva Therapeutics, LLC. (2023). Digoxin tablet [package insert]. DailyMed.
Pincus, M. (2016). Management of digoxin toxicity. Australian Prescriber.
Rehman, R., et al. (2023). Digitalis toxicity. StatPearls.
Sandoz Inc. (2020). Digoxin injection, solution [package insert]. DailyMed.
U.S. Food and Drug Administration. (2017). FY2015 Regulatory Science Research Report: Narrow therapeutic index drugs.
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