digoxin at a glance
Medicine class
Cardiac glycoside
Main roles
Controls certain supraventricular arrhythmias and supports treatment of systolic heart failure
Monitoring
Kidney function, electrolytes and signs of toxicity require review
Oral liquid
Measure with the supplied graduated pipette and do not dilute
What is digoxin used for?
Selected UK products are licensed for:
Chronic heart failure where systolic dysfunction is the dominant problem, particularly with atrial fibrillation.
Certain supraventricular arrhythmias, especially chronic atrial flutter and atrial fibrillation.
How does digoxin work?
Digoxin inhibits the sodium–potassium pump in heart cells, increasing calcium available for contraction. It also increases vagal activity and slows conduction through the atrioventricular node, which can reduce the ventricular rate in atrial fibrillation or flutter.
digoxin preparations and strengths
Oral solution
Route: Oral
Strengths: 0.05 mg/mL
Tablet
Route: Oral
Strengths: 62.5 micrograms, 125 micrograms, 250 micrograms
How to take digoxin
Follow the prescription label and do not change or stop treatment without discussing it with the prescriber.
Swallow tablets with water.
It may be taken with or without food, although very high-fibre meals can reduce absorption.
Measure oral solution only with the supplied graduated pipette; do not use a kitchen teaspoon or dilute it.
Injection or infusion is administered by healthcare professionals. Intramuscular administration is not recommended.
digoxin side effects
Common or expected effects
- Nausea, vomiting or diarrhoea
- Dizziness
- Blurred vision or altered colour vision
- Skin rash
- Slow, irregular or otherwise changed heartbeat
Get urgent medical advice
- A new fast, very slow or markedly irregular heartbeat, particularly with breathlessness or faintness
- Repeated vomiting, confusion, loss of appetite or yellow-green visual disturbance, which may indicate toxicity
- Severe allergic reaction with facial, mouth or throat swelling
- Severe weakness or collapse
digoxin in pregnancy
Digoxin can be used during pregnancy when specialist-supervised treatment is needed. Pregnancy may alter its handling, so symptoms, kidney function, electrolytes and blood concentrations may be reviewed. Do not stop treatment because of pregnancy without medical advice.
digoxin while breastfeeding
Digoxin passes into breast milk in very small amounts, and breastfeeding is generally compatible when the baby is healthy. Seek advice if the baby feeds poorly, gains weight unexpectedly slowly, or seems unusually pale or sleepy.
digoxin interactions
Digoxin has numerous clinically important interactions. Check new prescription, pharmacy and herbal products with a prescriber or pharmacist.
Amiodarone, verapamil or diltiazem
Can increase digoxin exposure and add to slowing of heart rate or atrioventricular conduction.
Beta blockers
Combined effects can produce excessive bradycardia or heart block.
Loop or thiazide diuretics and corticosteroids
Potassium depletion can increase sensitivity to digoxin and the risk of toxicity.
Common questions about digoxin
Answers are fully visible for fast scanning and source review.
How quickly does digoxin work?
Its effects on heart rate begin before symptom improvement is necessarily noticed. Improvement in heart-failure symptoms may take several weeks.
Why are blood tests needed?
Tests assess kidney function and potassium, magnesium and calcium, which affect digoxin safety. A digoxin concentration may be checked when toxicity, an interaction or altered clearance is suspected.
Can toxicity occur with a normal blood result?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.