Digoxin is used in the management of abnormal heart rhythm and treatment of heart failure (weakness and inability of the heart to pump blood).
This medicine may be used to treat other conditions as decided by your doctor.
Take Digoxin exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take it at the same time each day.
Digoxin is available as a tablet, elixir or oral solution.
If you are taking the oral solution, follow these steps:
- Remove the safety cap of the bottle and insert the oral syringe into the bottle.
- Pull back the plunger to the line that matches the dose prescribed by your doctor.
- Remove the oral syringe from the medicine bottle.
- Administer the medicine directly from the oral syringe by slowly pushing the plunger until the oral syringe is empty.
- Wash the oral syringe after use.
If you have been given the elixir, use the calibrated dropper provided to measure out your dose.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and response to the medication.
Digoxin must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- ventricular fibrillation (heart rhythm problem) or tachycardia (rapid heartbeat)
- irregular heartbeat caused by cardiac glycoside intoxication or conditions such as Wolff-Parkinson-White syndrome (a condition where there is an extra electrical pathway between your heart's upper and lower chambers, causing a rapid heartbeat)
- hypertrophic obstructive cardiomyopathy (abnormally thick heart muscle), unless associated with atrial fibrillation (irregular and often very rapid heart rhythm) and heart failure
- serious problems with the conduction of the electrical impulses in the heart, especially if you have a history of Stokes-Adams attacks (abrupt, short-lived loss of consciousness caused by a sudden change in heart rate or rhythm)
- constrictive pericarditis (inflammation of the sac-like membrane surrounding the heart), unless it is used to control heart rate in atrial fibrillation or to improve heart muscle contraction)
as Digoxin may not be suitable for you.
Inform your doctor if you have any of the following conditions:
- irregular or abnormal heartbeat
- recent heart attack
- sick sinus syndrome (abnormal heart rhythm due to problems with your heart's natural pacemaker)
- cardiac amyloidosis (a heart condition that occurs when plaques of protein by-product called amyloid build up in heart muscle, affecting its ability to pump blood)
- inflammation of the heart muscle
- beriberi heart disease (heart failure due to thiamine [vitamin B1] deficiency)
- severe lung disease
- hypoxia (deficiency of oxygen supply in the body)
- low levels of potassium or magnesium in the blood
- high levels of calcium in the blood
- thyroid disease
- increased metabolic activity
- kidney disease
- digestive problems or other bowel problems e.g. long-term diarrhoea
- long-term heart failure
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving this medicine to a child and the elderly. Children and elderly people may be more sensitive to the side effects.
If you will undergo cardioversion (a medical procedure for restoring a normal heart rhythm), inform your doctor that you are taking Digoxin.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. digoxin levels, heart rate/rhythm, electrolyte levels, kidney function) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Regular monitoring of signs of digoxin toxicity (e.g. confusion, loss of appetite, nausea, vomiting, diarrhoea, visual disturbance) may also be needed.
Digoxin may cause some problems with your eyesight (e.g. blurred or yellow-coloured vision). If affected, do not drive or take part in any activity in which you need to see clearly.
Other side effects include any of the following: headache, dizziness, nausea, vomiting, diarrhoea, stomach pain, weakness, swelling or enlargement of the male breasts and rash.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- signs and symptoms of digoxin toxicity e.g. confusion, loss of appetite, nausea, vomiting, diarrhoea
- palpitation
- irregular or abnormal heartbeat
- chest pain or any unusual sensations in the chest e.g. fluttering, pounding or jumping, skipped beats
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Digoxin if you are taking any of these medicines:
- anti-inflammatory medicines
- lithium salts
- calcium (especially if injected into the vein)
- carbenoxolone (medicine to treat stomach ulcers)
- certain water pills or medicines for water retention
- medicines known as sympathomimetics e.g. phenylpropanolamine, epinephrine
Inform your doctor and pharmacist if you are taking any of these medicines:
- certain antibiotics e.g. erythromycin, gentamicin, trimethoprim, neomycin
- medicines for heart disease e.g. amiodarone, quinidine, flecainide, propafenone, ranolazine, ticagrelor
- medicines for high blood pressure e.g. prazosin, carvedilol, telmisartan, verapamil, felodipine
- certain water pills or medicines for water retention e.g. hydrochlorothiazide, furosemide, spironolactone
- medicines for diabetes e.g. canagliflozin, acarbose
- medicine to treat viral infection e.g. daclatasvir, ritonavir, telaprevir, velpatasvir
- medicines to treat hyponatraemia (low sodium levels in the blood) e.g. tolvaptan, conivaptan
- gastric medicines e.g. omeprazole
- cholesterol-lowering medicines e.g. atorvastatin, colestyramine
- ciclosporin (medicine used in organ transplant or certain immune disorders)
- medicines for cancer e.g. lapatinib, vandetanib, venetoclax, vemurafenib
- NSAIDs (medicine for pain and inflammation) e.g. indometacin
- medicines for fungal infections e.g. itraconazole, isavuconazole
- medicines to treat depression e.g. nefazodone, bupropion
- medicines for constipation e.g. sennoside
- rifampicin (medicine to treat TB [infection known as tuberculosis])
- alprazolam (medicine for anxiety)
- quinine (medicine to treat malaria)
- suxamethonium (medicine for muscle relaxation)
- metoclopramide (medicine for stomach problems)
- phenytoin (medicines for fits or seizures)
- salbutamol (asthma medicine)
- sulfasalazine (medicine to treat inflammatory bowel diseases [inflammation in the lining of the digestive tract])
- flibanserin (medicine to treat women who have not gone through menopause and with low sexual desire)
- ivacaftor (medicine to treat cystic fibrosis [an inherited disorder that causes severe damage to the lungs, digestive system and other organs in the body])
- propantheline (medicine to treat stomach ulcers)
- mirabegron (medicine to treat overactive bladder)
- epoprostenol (medicine to treat high blood pressure in the lungs)
- kaolin-pectin (medicine to treat diarrhoea)
This list does not include all medicines that may interact with Digoxin.
Always inform your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol.
Do not take Digoxin together with foods rich in fibre such as bran. These foods may decrease the absorption of Digoxin.
Your doctor may give you potassium supplements while you are being treated with this medicine. Alternatively, he may tell you to eat more foods that are high in potassium, such as orange juice, bananas or prunes.
Store in a cool, dry place away from the reach of children. Protect from light.
Medicines must not be used past the expiry date.
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