Digoxin

Digoxin is used to treat heart failure and abnormal heart rhythms (arrhythmias). It helps the heart work better and it helps control your heart rate.

Digoxin comes as a tablet, capsule, or pediatric elixir (liquid) to take by mouth. Digoxin is usually taken once a day. The pediatric elixir comes with a specially marked dropper for measuring the dose. If you have difficulty, ask your pharmacist to show you how to use it. It is important that you always take the same brand of digoxin. Different brands of digoxin have different amounts of active drug and your dose would need to be changed.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take digoxin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Digoxin helps control your condition but will not cure it. Continue to take digoxin even if you feel well. Do not stop taking digoxin without talking to your doctor.

Digoxin is also used to treat heart pain (angina) and may be used after a heart attack. Talk to your doctor about the possible risks of using this drug for your condition.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Before taking digoxin,

• tell your doctor and pharmacist if you are allergic to digoxin, digitoxin, or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking digoxin. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• the following nonprescription or herbal products may interact with digoxin: antacids; esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec); St. John's wort; neomycin; activated charcoal; calcium supplements. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking digoxin. Do not start any of these medications while taking digoxin without discussing with your healthcare provider.
• tell your doctor if you have or have ever had thyroid problems, heart arrhythmias, cancer, or kidney disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking digoxin, call your doctor.
• talk to your doctor about the risks and benefits of taking this medication if you are 65 years of age or older. Older adults should usually receive low doses of digoxin because higher doses may cause serious side effects.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking digoxin.
• you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• remember that alcohol can add to the drowsiness caused by this medication.

Your doctor may recommend a low-sodium (low-salt) diet and a potassium supplement. Ask your pharmacist or doctor for a list of foods that are low in sodium and high in potassium. Follow all diet directions carefully.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Digoxin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• dizziness or lightheadedness
• drowsiness
• vision changes (blurred or yellow)
• rash
• irregular heartbeat

Some side effects may be serious. If you experience any of the following symptoms, call your doctor immediately:

• upset stomach
• vomiting
• diarrhea
• loss of appetite
• swelling of the feet or hands
• unusual weight gain
• difficulty breathing

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach. https://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor and the laboratory. Your doctor will need to determine your response to digoxin. You may have electrocardiograms (EKGs) and blood tests periodically, and your dose may need to be adjusted. Your doctor may ask you to check your pulse (heart rate). Ask your pharmacist or doctor to teach you how to take your pulse. If your pulse is faster or slower than it should be, call your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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