Digoxin

Digoxin is used to treat heart failure and a certain type of irregular heart beat called atrial fibrillation. It works by helping the heart to maintain a strong, steady heartbeat. It strengthens the force of your heart beat. It is one of a group of medicines known as cardiac glycosides. In New Zealand digoxin is available as tablets, in two strengths — 62.5 micrograms and 250 micrograms. It is also available as an injection which can be given in hospital. Read more about heart failure and atrial fibrillation.

• The usual dose of digoxin is 62.5 micrograms to 125 micrograms once a day.
• Some people may need a higher dose of 250 micrograms once a day.
• When you first start taking in you may need to take a higher dose to begin with.
• Always take your digoxin exactly as your doctor has told you.
• The pharmacy label on your medicine will tell you how much digoxin to take, how often to take it and any special instructions.

• Timing: Take digoxin at the same time each day, usually in the morning. You can take digoxin with or without food. If it causes an upset stomach, it may help to take it with food. 
• Missed dose: If you forget to take your dose, take it as soon as you remember that day. But, if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
• Keep taking digoxin every day. It may take several weeks to see the full benefit of digoxin. Treatment with digoxin is usually long term. Do not stop taking digoxin suddenly; speak to your doctor or nurse before stopping.

• Check your tablets: there are two strengths of digoxin tablets available – 62.5 micrograms (blue tablets) and 250 micrograms (white tablets). If your tablets look different to your last supply speak with your doctor or pharmacist for advice.
• Blood tests: you may need blood tests to make sure you are taking the correct dose of digoxin, especially if you have changes in your health or you start or stop other medicines.
• Signs that your dose may be too high: if you start being sick (vomiting), develop diarrhoea (runny poos), get blurred or other changes in your vision, or become very tired, you must contact your doctor straightaway. These are signs that the dose of digoxin may be too high for you.

• Do you have problems with your kidneys?
• Do you have thyroid problems?
• Do you have breathing problems?
• Have you recently had a heart attack?
• Are you pregnant or breastfeeding?
• Are you taking any other medicines? This includes any medicines you buy without a prescription, such as herbal and complementary medicines, or medicines you are only taking for a short time, such as antibiotics.

If so, it’s important that you tell your doctor or pharmacist before you start digoxin. Sometimes a medicine isn’t suitable for a person with certain conditions or it can only be used with extra care.

Like all medicines, digoxin can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Digoxin can be affected by other medicines and herbal supplements so check with your doctor or pharmacist before starting digoxin or before starting any new medicines.

Medsafe Consumer Information Sheets:

Lanoxin(external link)
Lanoxin PG(external link)  

Heart failure | Manawa ngoikore
Atrial fibrillation | Manawa tukituki

Digoxin(external link) NZ Formulary
Lanoxin(external link) Medsafe, NZ
Lanoxin PG(external link) Medsafe, NZ
An update on managing patients with atrial fibrillation(external link) BPAC, NZ, 2017
Management of atrial fibrillation in general practice(external link) BPAC, NZ, 2011
Managing patients with heart failure in primary care(external link) BPAC, NZ, 2013