The information on this site is intended to supplement and enhance, not replace, the advice of a physician who is familiar with your medical history. Decisions about your health should always be made ONLY after detailed conversation with your doctor.
Generic drug name:
digoxin
(di JOX in)
Brand name(s):
DIGITEK,
LANOXICAPS,
LANOXIN
GENERIC:
available
FAMILIES:
Drugs for Abnormal Heart Rhythm, Heart Failure & Angina
Find the drug label by
searching at DailyMed.
Pregnancy and Breast-feeding Warnings [top]
Pregnancy Warning
No data are available for digoxin as it was not tested in animal studies. Use during pregnancy only for clear medical reasons. Tell your doctor if you are pregnant or thinking of becoming pregnant before you take this drug.
Breast-feeding Warning
Digoxin is excreted in human milk with the concentration in the milk about the same as in the mother’s blood. Because of the potential for serious adverse effects in nursing infants, you should not take this drug while nursing.
Facts About This Drug [top]
Digoxin is approved by the Food and Drug Administration (FDA) for the treatment of mild to moderate heart failure. It is often used in combination with a thiazide diuretic or water pill, as well as an angiotensin-converting enzyme (ACE) inhibitor. The symptoms of heart failure are fatigue, difficulty breathing, swelling (especially in the legs and ankles) and rapid or “galloping” heartbeats.
Digoxin is also approved to control the rate of beating of the large chambers of the heart...
Digoxin is approved by the Food and Drug Administration (FDA) for the treatment of mild to moderate heart failure. It is often used in combination with a thiazide diuretic or water pill, as well as an angiotensin-converting enzyme (ACE) inhibitor. The symptoms of heart failure are fatigue, difficulty breathing, swelling (especially in the legs and ankles) and rapid or “galloping” heartbeats.
Digoxin is also approved to control the rate of beating of the large chambers of the heart (ventricles) in people with atrial fibrillation, the most common disorder of the heart's rhythm, or arrhythmia.[1] Atrial fibrillation can cause palpitations (feelings that the heart is skipping a beat, fluttering, or beating too hard or fast), shortness of breath, chest pain, dizziness and fatigue. In many patients, the condition causes no symptoms.
Before prescribing digoxin for heart failure, doctors should first try administering a thiazide diuretic. Patients should be switched to digoxin only if the diuretic does not control symptoms well enough. In general, a patient over 60 years of age should take a smaller daily dose than the usual 0.25 milligrams,[2] especially if the patient has impaired kidney function.
Side effects
Anyone taking digoxin is at risk of toxic effects (digitalis toxicity). While a patient is taking digoxin, the doctor should regularly check the levels of the drug in the blood. Both the patient and the doctor should also watch for the subtle symptoms of toxicity: fatigue, loss of appetite, nausea and vomiting, problems with vision, bad dreams, nervousness, drowsiness, and hallucinations.[3] Other signs of toxicity are changes in heart rhythm, slow pulse and lethargy. Since there is a narrow range between a helpful and a harmful amount of digoxin in the body, patients should take the drug daily in the exact amount prescribed. If too much digoxin enters the body, the patient may experience the effects listed above. If there is too little digoxin, a patient may develop symptoms of heart failure or a rapid heart rate.
The abrupt onset of dementia has been associated with digoxin use. The dementia is reversible when digoxin use is stopped.[4]
Studies show ...
An article published in the Journal of Clinical Oncology presented information from a Denmark study on the incidence of breast cancer in women using digoxin and in women using angina drugs. The study found that women using digoxin had an increased risk of breast cancer and that risk normalized when digoxin was discontinued. However, the authors of the study stated the following in their conclusion:
Although the digoxin effect we observed was similar to that of postmenopausal estrogens, it was nevertheless small, and the importance of digoxin to the clinical management of heart disease may outweigh our inferences regarding increased risks of breast cancer.[5]
A study published in Pharmacoepidemiology and Drug Safety in 2014 showed that treatment with digoxin was associated with a higher risk of colorectal cancer.[6]
Information from a study published in the European Heart Journal examined the incidence of increased mortality in patients with atrial fibrillation taking digoxin. According to the study, this effect was observed in both men and women and was seen in patients with or without underlying heart failure.[7]
In 2015, a meta-analysis (a study analyzing results from several different studies) in the American Journal of Cardiology showed that there was an increased risk of mortality in patients with atrial fibrillation taking digoxin. The risk was found in patients with and without heart failure.[8]
A similar meta-analysis in 2015 in the European Heart Journal also showed that patients with either atrial fibrillation or congestive heart failure who took digoxin had an increased risk of mortality.[9]
Another meta-analysis published in Medicine in 2015 showed that digoxin was associated with a higher risk of mortality in atrial fibrillation patients without heart failure compared with atrial fibrillation patients with heart failure.[10]
Misprescribing and conditions for ceasing digoxin treatment
Digoxin is often overprescribed for older adults.[11] One study of people using digoxin outside the hospital found that 4 out of 10 received no benefit from the drug.[12] Because of digoxin’s toxic effects, taking the drug without any benefit is both wasteful and dangerous. As many as 1 in 5 digoxin users develop signs of toxic effects,[13] and much of this could be prevented if the people who did not need digoxin were taken off the drug. Evidence shows that up to 8 out of 10 long-term digoxin users can successfully stop using the drug, under close supervision by a doctor, with no harmful results.[14] This is partly due to digoxin being wrongly prescribed in the first place.
If you have used digoxin regularly for some time, ask your doctor if you might be able to try withdrawing from the drug. You are more likely to be able to stop taking digoxin if you meet the following conditions:
There is no precise way to know in advance who can stop taking digoxin. People taking digoxin to correct an irregular heart rhythm should not attempt to stop taking the drug, but most other people will benefit from a trial of withdrawal under close supervision by a doctor.
Drug Interaction
In 2017, the FDA approved a change to the product label of bupropion that indicated that the blood level of heart drug digoxin may increase when bupropion and digoxin are used together.[15]
Before You Use This Drug [top]
Do not use if you have or have had:
Tell your doctor if you have or have had:
Tell your doctor about any other drugs you take, including aspirin, herbs, vitamins, and other nonprescription products.
When You Use This Drug [top]
How to Use This Drug [top]
Interactions with Other Drugs [top]
The following drugs, biologics (e.g., vaccines, therapeutic antibodies), or foods are listed in Evaluations of Drug Interactions 2003 as causing “highly clinically significant” or “clinically significant” interactions when used together with any of the drugs in this section. In some sections with multiple drugs, the interaction may have been reported for one but not all drugs in this section, but we include the interaction because the drugs in this section are similar to one another. We have also included potentially serious interactions listed in the drug’s FDA-approved professional package insert or in published medical journal articles. There may be other drugs, especially those in the families of drugs listed below, that also will react with this drug to cause severe adverse effects. Make sure to tell your doctor and pharmacist the drugs you are taking and tell them if you are taking any of these interacting drugs:
ACHROMYCIN, ADVIL, ALDACTONE, alprazolam, aluminum hydroxide, amiodarone, AMPHOJEL, ANECTINE, antacids, arbutamine hydrochloride, atorvastatin, AZULFIDINE, BIAXIN, CALAN SR, CALCIJECT, calcium chloride injection, CAPOTEN, captopril, cholestyramine, clarithromycin, CORDARONE, COVERA HS, CUPRIMINE, cyclophosphamide, cyclosporine, CYTOXAN, DELTASONE, DEPEN, diazepam, DILANTIN, diphenoxylate, DURAQUIN, EES, ERYTHROCIN, erythromycin, furosemide, GAVISCON, GLUCOVANCE, hydroxychloroquine, ibuprofen, INDOCIN, indomethacin, ISOPTIN SR, itraconazole, kaolin and pectin, KAO-SPEN, KAPECTOLIN, LASIX, LIPITOR, LOCHOLEST, LOMOTIL, magnesium hydroxide, magnesium trisilicate, MATULANE, metformin, METICORTEN, metoclopramide, MICARDIS, MINIPRESS, MOTRIN, neomycin, NEORAL, NEO-RX, ONCOVIN, PANMYCIN, paricalcitol, penicillamine, phenytoin, PHILLIPS’ MILK OF MAGNESIA, PLAQUENIL, potassium-depleting diuretics, prazosin, prednisone, PRO-BANTHINE, procarbazine, propafenone, propantheline, QUESTRAN, QUINAGLUTE DURA-TABS, QUINIDEX, quinidine, REGLAN, RYTHMOL, SANDIMMUNE, spironolactone, SPORANOX, succinylcholine, sulfasalazine, telmisartan, tetracycline, THYROID STRONG, tramadol, ULTRAM, VALIUM, VERELAN, verapamil, vincristine, XANAX, ZEMPLAR.
Adverse Effects [top]
Call your doctor immediately if you experience:
Periodic Tests[top]
Ask your doctor which of these tests should be done periodically while you are taking this drug:
last reviewed June 30, 2020
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