What Is Digoxin (Lanoxin)?

Reviewed by: HU Medical Review Board | Last reviewed: March 2022 | Last updated: April 2022

There are numerous classes of drugs approved to treat heart failure (HF). Digoxin, known by the brand name Lanoxin®, is a cardiac glycoside indicated for the treatment of mild to moderate heart failure in adults. It also is approved to increase heart contractions in pediatric patients with heart failure and to control the resting ventricular rate in adults with chronic atrial fibrillation. Use of digoxin as a treatment for HFrEF lacks new data; most of its use in modern HFrEF management focuses on its role as a rate control agent for atrial fibrillation (AF) in those with low blood pressure.1

Digoxin increases left ventricular ejection fraction and improve heart failure symptoms including improved exercise capacity and fewer heart failure-related hospitalizations and need for emergency care.1

It is usually prescribed together with a diuretic and an angiotensin-converting enzyme (ACE) inhibitor.1

Digoxin can be prescribed when patients are initially diagnosed with systolic heart failure for more immediate symptoms relief or in patients who are being treated with ARNI/ACE inhibitor/, ARB's, Beta-blocker and aldosterone antagonists that continue to have symptoms.

Digoxin (or digitalis) is one of the cardiac glycosides, a class of drugs that have specific effects on the myocardium (the muscular tissue of the middle layer of the wall of the heart). Digoxin is extracted from the leaves of Digitalis lanata plant. Digitalis refers to glycosides in general.

How does digoxin work?

Digoxin is a drug that has been used in heart failure treatment for years. It works by helping the heart to beat stronger and with a more regular rhythm.2 Treatment goals are to reduce symptoms and help people feel better as well as to reduce the risk of a heart failure hospitalization.

What are the possible side effects of digoxin?

Any medication has possible adverse effects, and it’s important to be aware of the potential side effects when starting a new drug. Common side effects include coughing, dizziness, and lightheadedness. Some people experience lower blood pressure (hypotension), increased potassium (hyperkalemia), and increased serum creatinine levels.1-2 Do not take Digoxin if you have a history of heart block that has not been treated with a pacemaker.

These are not all the possible side effects of digoxin (Lanoxin). Patients should talk to their doctor about what to expect with treatment with digoxin (Lanoxin).

Things to know about digoxin

Digoxin is available in tablet form:

  • Unscored tablets in one strength: 62.5 mcg
  • Scored tablets in two different strengths of 125 and 250 mcg

A digoxin solution can be substituted to obtain the appropriate dose in infants, young pediatric patients, or patients with very low body weight.1 It is also available as an intravenous injection (IV).1

You should not take digoxin if you are allergic to digoxin or any of its ingredients.2

When taking digoxin, your healthcare team will monitor for signs and symptoms of digoxin toxicity and clinical response - how well the medicine is working. It may be necessary to adjust the dose based on toxicity, efficacy, and blood levels. People taking digoxin should monitor and record their heart rate and blood pressure daily. Routine blood tests including a digoxin blood level are necessary to ensure that the digoxin dose is appropriate and to evaluate kidney function.1

Be sure to tell the doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Different medicines can interact with each other and may affect the way they work or cause serious side effects.1-2

Do not take digoxin if you have ventricular fibrillation.1-2

Talk to your doctor before starting digoxin if you:

  • Have had a heart attack
  • Have Wolff-Parkinson-White Syndrome
  • Have kidney disease
  • Have an electrolyte imbalance
  • Have a thyroid disorder

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