About Lanoxin
This digitalis preparation acts to strengthen the heart muscle
and allow it to work harder. It also helps to restore proper rhythm
by delaying electrical transmission through the heart. It is approved
for use in atrial fibrillation, atrial flutter, atrial/supraventricular
tachycardia, and congestive heart failure.
Other conditions for which it might be prescribed include; improving
left ventricular function in combination with pacemakers, postoperative
arrhythmia, and treating Wolff-Parkinson-White syndrome. But please
note that though digitalis treatments have been prescribed for weight
loss, this is potentially hazardous and is strongly discouraged.
Digoxin is only available by prescription.
Lanoxin Side Effects
Mild Side Effects: Dark or black feces, enlargement or tenderness
of male breast (rare), slow heart rate.
Possible Side Effects: Allergy (hives, rash), altered vision
(blurring, halos, seeing double, spots, yellow-green tinge), confusion,
decreased appetite, decreased libido (male), drowsiness, lethargy,
nausea or vomiting, nightmares, vaginal cornification (case reports
in post-menopausal women). Consult your doctor as soon as possible
if any of these side effects occur or seem particularly severe.
Serious Side Effects: Blindness, disorientation, hallucinations,
heart rhythm changes, facial or peripheral neuralgia (nerve pain),
psychosis, seizure, severe skin rash. If any of these rare side
effects occur, seek medical treatment immediately. If your doctor
is not available, or your symptoms are especially severe, seek emergency
treatment right away.
Cautions: This medication is not right for everyone, and
some individuals may have special dosing requirements or need other
precautions taken. Speak to your doctor if you have a history of
any of the following.
- Allergies: Inform your doctor of any medication, food,
or dye allergies. If you have ever had an allergic or bad reaction
to digitalis, your doctor may not want to use this treatment.
- Electrolyte Disorders: Your heart may be more sensitive
to the effects of digitalis.
- Heart Disease: Your heart may be more sensitive to the
effects of digitalis.
- Heart Rhythm Disorders: These problems may be worsened.
- Kidney or Liver Disease: Digitalis' effects may be increased,
as it may clear more slowly from the body.
- Lung Disease: Your heart may be more sensitive to the
effects of digitalis.
- Thyroid Disease: Hyper- or Hypo-Thyroidism may alter
the way you respond to digitalis.
Lanoxin Interactions
Certain medication may interact with the digitalis preparation Lanoxin (digoxin). Some medications will require dosing adjustments, or may be mixed even though an interaction may occur, and some should not be used together at all. Make sure your doctor knows if you're taking any of the following. If you see multiple physicians, be certain that each of them has an updated list of medications you're taking, both prescription and over the counter.
- Acid-reflux treatments like Nexium (esomeprazole) and Prilosec
(omeprazole) may increase the effects of treatment.
- Adriamycin (doxorubicin) - May decrease the effectiveness of
treatment.
- Aldactone (spirinolactone) - May increase digoxin's effects.
- Allergy Treatments - Over the counter allergy medications should
not be used without consulting first with your doctor.
- Amphotericin B - Effects of treatment may be increased.
- Antacids - Over the counter antacids should not be used without
consulting first with your doctor. Antacids containing aluminum
can decrease the effectiveness of treatment.
- Antibiotics - Several classes of antibiotics interact
with Lanoxin. If you need to be treated with antibiotics while
using this medication, inform the prescribing doctor that you
take a digitalis preparation to ensure safe and effective treatment.
- Antifungals like Diflucan (fluconazole),
Nizoral (ketoconazole), Sporanox (itraconazole), and possibly
others may increase the effects of this medication.
- Benzodiazepines (a class of antidepressants, anti-panic agents,
sleep medications, and muscle relaxants) such as Ativan
(lorazepam), Dalmane (flurazepam), Valium
(diazepam), Halcion (triazolam),
Librium(chlordiazepoxide),
Restoril (temazepam), Xanax
(alprazolam), Tranxene-SD (clorazepate), Paxipam (halazepam),
ProSom (estazolam), Klonopin
(clonazepam), and others, may increase digoxin's effects.
- Beta Blockers - Drugs like Blocadren (timolol), Cartrol (carteolol),
Corgard (nadolol), Inderal
(propranolol), Kerlone (betaxolol), Levatol (penbutolol),
Lopressor (metoprolol),
Normodyne (labetalol), Sectral (acebutolol), Sotacor (sotalol),
Tenormin (atenolol), Trasicor (oxprenolol ), or Visken (pindolol)
may lower heart rate undesirably when used with digitalis preparations.
The beta blocker drops administered by eye as a treatment for
glaucoma may also interact with verapamil, speak to your doctor
if you take Betagan (levobunolol), Betoptic (betaxolol), OptiPranolol
(metipranolol), or Timoptic (timolol) drops.
- Bactrim (cotrimoxazole) - May increase effects of treatment.
- BiCNU (carmustine) - May decrease the effectiveness of digoxin.
- Blenoxane (bleomycin) - May decrease the effects of treatment.
- Calcium channel blockers - Medications like Bepadin (bepridil),
Calan (verapamil), Cardene (nicardipine), Cardizem (diltiazem),
DynaCirc (isradipine), Nimotop (nimodipine), Plendil (felodipine),
Procardia (nifedipine),
or Sibelium (flunarizine) may cause digoxin to build up in the
body.
- Calcium, Intravenous - Reaction could prove fatal. Calcium supplements
taken by mouth are fine.
- Capoten (captopril) - Effects of treatment may be increased.
- Carafate (sucralfate) - May decrease the effectiveness of digoxin
treatment.
- Colestid (colestipol) - May decrease the effectiveness of digoxin
treatment.
- CoQ10 - This vitamin supplement may affect heart function. While
the effects are typically beneficial, they may alter the effects
of digoxin. Speak to your doctor if you take this supplement,
and have your blood levels checked more frequently until your
treatment has been optimized.
- Cordarone (amiodarone) - May increase the effects of digoxin
treatment.
- Cough and Cold Medicine - Over the counter cold medications
should not be used without consulting with your doctor.
- Cytosar (cytarabine) - May decrease the effectiveness of treatment.
- Cytoxan (cyclophosphamide) - May decrease the effectiveness
of digoxin treatment.
- Desyrel (trazodone) - May increase
effects of digoxin.
- Digibind (digoxin immune Fab) - Will increase blood levels.
These medications may sometimes be prescribed together to take
advantage of this effect.
- Dilantin (phenytoin) -
May increase the effects of digoxin treatment.
- Diuretics of any sort, with the exception of Aldactone (spironolactone)
and Diazide (triamterene), can cause potassium loss and result
in serious heart problems.
- Donnagel (kaolin/pectin) - May decrease effectiveness of digoxin.
- Ethacrynic acid - May increase the effects of digoxin.
- Glucophage (metformin) - Levels of this medication may increase
when combined with digoxin, lowering blood sugar too far. Dosage
adjustments may be necessary.
- Glyset (miglitol) - May decrease effectiveness of digoxin.
- HMG-CoA reductase inhibitors (statins) - Drugs like Lescol (fluvastatin),
Lipitor (atorvastatin),
Mevacor (lovastatin), Pravachol (pravastatin), or Zocor (simvastatin)
may increase the effects of digoxin. Your doctor will need to
check blood levels more frequently and perhaps adjust dosage.
- Hydroxychloroquine - Can increase the effects of digoxin.
- Norpace (disopyramide) - May increase effects of digoxin treatment.
- Magnesium - Keep in normal range, speak to your doctor about
any supplements you may be taking.
- Matulane (procarbazine) - May decrease the effectiveness of
digoxin treatment.
- Mexate (methotrexate) - Digoxin may be less effective with combined
treatment.
- Micardis (telmisartan) - May increase the effects of digoxin.
- Midamor (amiloride) - Effects of treatment may be increased.
- Non-Steroidal Anti-Inflammatories, or NSAIDs, such as Butazolidine
(phenylbutazone), Clinoril (sulindac),
Ibuprofen (Motrin), Indocin (indomethacin), Naprosyn (naproxen),
Toradol (ketorolac), and
others, may increase the effects of digoxin.
- Norcuron (vecuronium) or Pavulon (pancuronium) - These neuromuscular
blocking agents may may cause abnormal heartbeat, or arrhythmia,
when combined with digoxin.
- Oncovin (vircristine) - Digoxin may be less effective in combination.
- Orinase (tolbutamide) - May increase digoxin's effects.
- Posicor (mibefradil) - May increase the effects of treatment.
- Potassium - Keep in normal range. Speak to your doctor about
vitamin supplements and potassium rich foods.
- Precose (acarbose) - May decrease digoxin blood levels, making
treatment less effective.
- Propacil (propylthiouracil) - May increase the effects of digoxin.
- Protease inhibitors such as Agenerase (amprenavir), Norvir (ritonavir),
and perhaps others, may lead to higher levels of digoxin in the
body.
- Questran (cholestyramine) - May decrease the effectiveness of
treatment.
- Quinidine - May decrease the effectiveness of treatment, and
increase the risk of toxic side effects.
- Quinine - May increase the effects of digoxin.
- Reglan (metoclopramide) - May decrease the effectiveness of
digoxin.
- Rhythmol (propafenone) - May increase blood levels of digoxin
from 30-100%.
- Rifabutin and Rifampin may decrease the effectiveness of digoxin
treatment.
- Sandimmune (cyclosporine) - May increase effects of digoxin.
- Selective serotonin reuptake inhibitors (SSRIs) like Celexa
(citalopram), Paxil (paroxetine),
Prozac (fluoxetine), Luvox (fluvoxamine), or Zoloft (sertraline)
may alter the effects of treatment.
- Septra (trimethoprim) - May increase effects of digoxin treatment.
- Serzone (nefazadone) - May increase effects of digoxin treatment.
- St. John's Wort - This herb may make your treatment less effective,
do not combine.
- Succinylcholine - Abnormal heart rhythms may result from this
combination.
- Sulfasalazine - Digoxin may be less effective.
- Synercid (quinupristin/dalfopristin) - May increase the effects
of digoxin.
- Tambocor (flecainide) - May increase the effects of digoxin.
- Tapazole (methimazole) - This thyroid medication may increase
the effects of treatment.
- Tequin (gatifloxacin) - May increase effects of digoxin treatment.
- Thyroid hormones - Digoxin may be less effective in combination
with these treatments.
- Tikosyn (dofetilide) - Increased risk of abnormal heart effects.
The cause is unclear, but caution is advised.
- Ultram (tramadol) - May increase
effects of digoxin.
Lanoxin Dosages
Precise dosing must be determined for each individual by body weight.
After the initial loading doses as determined by your doctor, the
medication is usually taken once a day at the same time each day.
Lanoxin is available in the following forms:
- Capsules - 0.05 mg, 0.1 mg, 0.2 mg
- Elixir - 0.05 mg/ml (pediatric), 0.25 mg/5 ml, 0.125 mg/5 ml
- Tablets - 0.125 mg, 0.25 mg, 0.5 mg
Follow your doctor's instructions exactly when taking your medication.
Also, stay on the same brand or generic treatment every time you
get your prescription refilled. If you change brands, your doctor
may have to recheck blood levels and change your dose.
Lanoxin Directions
If you miss a dose, take it at once if you remember within 12 hours.
If it has been more than 12 hours since the missed dose, skip it
and wait until your next regularly scheduled dose. Do not take double
doses of medication, and speak to your doctor if you miss more than
one dose.
Tablets may be crushed, and are best taken on an empty stomach
at the same time each day. Speak to your doctor about high potassium
foods, as the amount of the medication that enters the body may
be decreased if taken with food. Avoid high caffeine drinks like
coffee, cola, or tea. This medication can be taken with milk, which
will slow, but not change absorption.
Nicotine in cigarettes, chewing tobacco, and cigars, may irritate
the heart muscle and increase the risk of rhythm disorders.
Carry medical ID to indicate that you use this medicine in case
of emergency.
The elixir form should be shaken thoroughly before measuring. Do
not allow it to freeze, store as recommended on the packaging.
Store Lanoxin away from direct light and heat. Store in a dry location; avoid storing it in the bathroom, near sinks, or other areas where it may become damp. Do not use after the expiration date.
Keep Lanoxin away from children; both when storing it, and when discarding any unused medication.
Lanoxin and Pregnancy
No studies of this medication have been performed during pregnancy,
though no birth defects have been reported from its use. Speak to
your doctor if you are, or are planning to become, pregnant.
Lanoxin may pass into breast milk. Nursing should be discontinued
if unwanted side effects develop.
Lanoxin and Children
This medication has been approved for infants and children, and does not appear to cause different side effects in them than in adults. Dosages will have to be calculated exactly for each individual child by a doctor.
Lanoxin and Seniors
Smaller doses recommended, your doctor will determine an appropriate
level of medication. Individuals over 60 years of age should watch
for the symptoms of toxic build up, including: agitation, confusion,
delusions, depression, diarrhea, dizziness, fatigue, headache, lethargy,
nervousness, trouble reading. If these symptoms are noticed, contact
your doctor.
Post-menopausal women may experience cornification of the vagina.
This has been mistaken for endometrial cancer, and any symptoms
indicating such a condition should be investigated as a possible
drug reaction.
Lanoxin is a trademark of GlaxoSmithKline
Digitek is a trademark of Bertek
Generic Digoxin is manufactured by Elkins-Sinn, Roxane, and Wyeth-Ayerst
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The information contained in this document is provided for educational purposes
and information only. It is not a
substitute for consultation with a physician or Health professional, either to diagnose
symptoms or prescribe treatment. Any dosages mentioned are general
guidelines only, please follow the directions of your doctor or
pharmacist exactly when taking medication. We have made every effort to
ensure that this information is accurate, but only your doctor,
physician or Health professional can say
if a medication, a drug alternative or drug combination, is safe for you. Information
intended for US residents only.
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