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Indication & Dosage |
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| Oral |
| MANAGEMENT OF SUPRAVENTRICULAR ARRHYTHMIAS, ATRIAL FIBRILLATION AND HEART FAILURE |
| Adult:
Rapid digitalisation: loading dose of 0.75-1.5 mg during the first 24-hr period. Less urgent digitalisation: 250 mcg once or twice daily. Maintenance: Usually, 125-250 mcg daily but may also range from 62.5-500 mcg daily. High doses should be given in divided doses.
Elderly: Lower doses are given. |
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| Intravenous |
| EMERGENCY CASES |
| Adult:
If the patient has not received cardiac glycosides in the previous 2 wk. 0.5-1 mg by IV infusion as a single dose over at least 2 hr or in divided doses, each given over 10-20 minutes. Maintenance dose is usually given orally. |
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| Administration |
May be taken with or without food. |
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| Precautions |
Cardiac dysrhythmias, hypokalaemia, hypertension, IHD, hypercalcaemia, hypomagnesaemia, electroconversion, chronic cor pulmonale, aortic valve disease, acute myocarditis, congestive cardiomyopathies, constrictive pericarditis, heart block, elderly, renal impairment, abnormalities in thyroid function; pregnancy. IV digoxin can only be given to patients who have not received cardiac glycosides in the preceding 2 wk. |
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Potentially Life-threatening
Adverse Drug Reactions |
Extra beats, anorexia, nausea and vomiting. Diarrhoea in elderly, confusion, dizziness, drowsiness, restlessness, nervousness, agitation and amnesia, visual disturbances, gynaecomastia, local irritation (IM/SC inj), rapid IV admin may lead to vasocostriction and transient hypertension. |
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| Adverse Drug Reactions |
Cardiac arrhythmias in combination with heart block. |
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| Interactions |
Effectiveness reduced by phenytoin, neomycin, sulphasalazine, kaolin, pectin, antacids and in patients receiving radiotherapy. Metoclopramide may alter the absorption of solid dosage forms of digoxin. Blood levels increased by calcium channel blockers, spironolactone, quinidine and calcium salts. |
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