INDICATIONS

Digoxin is used for treating heart failure and slowing the heart rate in patients with chronic atrial fibrillation, a type of abnormal heart rhythm. Digoxin is a digitalis glycoside. It works by increasing the force of contraction of the heart and slowing heart rate.

INSTRUCTIONS 

Use Digoxin as directed by your doctor.

• Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.
• Take Digoxin with a full glass of water.
• Try to take the medication at the same time every day.
• To be sure Digoxin is not causing harmful effects, your blood may need to be tested on a regular basis. Your kidney function may also need to be tested. Do not miss any scheduled appointments.
• Keep taking Digoxin as directed, even if you feel well. Get your prescription refilled before you run out of medicine completely.
• Do not stop taking Digoxin without first talking to your doctor. Stopping suddenly may make your condition worse. 
•  If you miss a dose of Digoxin, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Digoxin.

STORAGE

 Store Digoxin at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Digoxin out of the reach of children and away from pets.

Do NOT use Digoxin if:

• you are allergic to any ingredient in Digoxin or other digitalis medicines
• you have beriberi heart disease
• you have certain types of heart rhythm problems, such as ventricular fibrillation.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Digoxin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have severe heart failure, inflammation of the heart, coronary artery disease, heart attack, heart block, extra heart beats (PVCs), certain abnormal heart rhythms, or fainting due to a heart problem
• if you have severe kidney, liver, or lung problems, or a thyroid problem
• if you have low blood levels of calcium, magnesium, or potassium, or high blood levels of potassium or calcium.

Some medicines may interact with Digoxin. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Amiodarone, amphotericin B, anticholinergics (eg, propantheline), beta-blockers (eg, propranolol), bupivacaine, calcium, certain stimulants (eg, albuterol, amphetamine, pseudoephedrine), cyclosporine, diltiazem, diphenoxylate, diuretics (eg, hydrochlorothiazide, furosemide), indomethacin, itraconazole, macrolides (eg, erythromycin), propafenone, quinidine, quinine, spironolactone, succinylcholine, tetracyclines (eg, doxycycline), thioamines (eg, methimazole), or verapamil because they may increase the risk of Digoxin's side effects, especially on the heart
• Acarbose, certain anticancer medicines, cholestyramine, colestipol, kaolin-pectin, metoclopramide, penicillamine, rifampin, sulfasalazine, or thyroid hormones (eg, levothyroxine) because they may decrease Digoxin's effectiveness
• Oral aminoglycosides (eg, neomycin) because the actions and side effects of Digoxin may be increased or decreased
• Spironolactone because it may interfere with certain lab tests for digoxin blood levels and give false readings.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Digoxin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

• Digoxin may cause dizziness or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Digoxin with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Tell your doctor or dentist that you take Digoxin before you receive any medical or dental care, emergency care, or surgery.
• Lab tests, including electrocardiogram (ECG), electrolytes, and blood digoxin levels, may be performed while you use Digoxin. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use Digoxin with caution in the elderly; they may be more sensitive to its effects.
• Use Digoxin with extreme caution in infants who are premature or immature; they may be more sensitive to its effects.
• Poisoning may occur in children who accidently swallow Digoxin or receive too much medicine. In case of an overdose, call a doctor or poison control center right away.
• Pregnancy and breast-feeding: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Digoxin while you are pregnant. Digoxin is found in breast milk. If you are or will be breast-feeding while you use Digoxin, check with your doctor. Discuss any possible risks to your baby.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome:

Diarrhea; nausea.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision, yellow vision, or other vision changes; confusion; fast, slow, or irregular heartbeat; hallucinations; mood or mental changes (eg, depression); severe or persistent nausea, vomiting, or stomach pain; unusual bruising or bleeding; unusual tiredness or weakness.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects.