OralAtrial fibrillation, Atrial flutter, Chronic heart failureAdult: Initially, 2 mg/day until clinical improvement or for 3-7 days. Maintenance: 250 mcg to 1 mg/day.
Child: Infant: Initially, 200-300 mcg/day. Maintenance: 100-150 mcg/day. 1-5 yr: Initially 300-600 mcg/day. Maintenance 100-200 mcg/day. >5 yr: 600 mcg to 1 mg/day. Maintenance: 250 mcg/day.
Elderly: Reduce dose.
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Woff-Parkinson-White syndrome; hypertrophic obstructive cardiomyopathy; ventricular fibrillation.
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CV disease; partial heart block, sinus node disorders, acute myocarditis, chronic constrictive pericarditis, acute MI, severe heart failure, severe pulmonary disease, hypokalaemia, hypomagnesaemia, hypercalcaemia, hypoxia, myxoedema, acute glomerulonephritis. Renal impairment. Elderly. Neonates. Lactation.
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Nausea, vomiting, anorexia, diarrhoea, abdominal pain, headache, facial pain, fatigue, weakness, dizziness, drowsiness, disorientation, mental confusion, bad dreams, delirium, acute psychoses, hallucinations, convulsions, blurred vision, disturbance in colour vision, thrombocytopenia, gynaecomastia.
Potentially Fatal: May cause or aggravate heart failure; supraventricular or ventricular arrhythmias; conduction abnormalities.
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Increased risk of cardiac glycoside toxicity with drugs that produce electrolyte imbalance (e.g. diuretics, amphotericin B, corticosteroids, corticotropin, edetate disodium, laxatives, sodium polystyrene sulfonate, glucagon, large doses of dextrose, dextrose-insulin infusions). Synergistic inotropic and toxic effects with calcium. Additive negative effects on AV conduction with β-blockers, calcium-channel blockers. Increased risk of arrhythmias with sympathomimetics, rauwolfia alkaloids.
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False-positive ST-T segment changes during exercise testing.
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Description: Lanatoside exerts positive inotropic effect by increasing the concentration of intracellular calcium, thereby increasing myocardial contraction.
Pharmacokinetics:
Absorption: About 60% is absorbed (oral); peak plasma concentration after 1 hr.
Distribution: Protein-binding: 25%, to albumin; detected in breast milk.
Excretion: Via urine (23% as digoxin and metabolites after oral admin; as unchanged drug after IV) and via faeces.
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