Digoxin

What is digoxin?

Digoxin is a prescription only medicine used to treat heart conditions. It belongs to a group of medicines called cardiac glycosides – these are derived from the foxglove plant. Digoxin helps the heart work more efficiently and control its rhythm, easing the symptoms of different conditions[1]. 

What is digoxin used for?

Digoxin can be used in the management of heart failure, especially when other treatments have not worked well. It may also be prescribed for arrythmias (an irregular heartbeat) such as atrial fibrillation and atrial flutter[1]. 

How does digoxin work?

Digoxin works in two main ways. First, it slows down the heart rate. This is especially helpful for people with atrial fibrillation, putting more control over the rhythm. It also increases the force of heart muscle contractions, which helps the heart pump blood more effectively in cases of heart failure[1]. 

Who can take digoxin?

Digoxin can be suitable for adults and children when it’s prescribed by a specialist. It may not be appropriate for people who have[1]: 

• Had an allergic reaction to digoxin 

• Certain serious heart conditions such Stokes-Adams attacks, a recent heart attack, a heart block, or an enlargement of the heart muscle  

• Certain heart rhythm conditions such as Wolff-Parkinson-White syndrome 

• Kidney problems 

• Stomach or bowel conditions 

• Severe lung disease or asthma 

• Electrolyte disturbances such as low potassium or magnesium levels, or high blood calcium levels  

• Thyroid disorders 

• Thiamine (vitamin B1) deficiency 

It’s also not usually prescribed for those who are pregnant or breastfeeding.  

Please tell your doctor or pharmacist about any conditions you may have before you start digoxin treatment and always follow the instructions in the Patient Information Leaflet[2].

How do you take digoxin?

It’s important to take digoxin at the same time each day. You can take it with or without food, swallowing tablets whole with water. Most people take it once a day and in the morning after breakfast.  If you are prescribed the liquid form, it is important to use the measuring spoon or oral syringe provided with the medication to ensure you are taking the correct dose. Kitchen teaspoons are not reliable and may lead to incorrect dosing[1]. 

What is the typical dosage of digoxin?

The correct dose of digoxin can vary based on many factors, including age, weight, kidney function, and the condition being treated. Most people take it once a day, although it may be split into two doses in some cases[1].  

You may be asked to take several tablets or amounts of liquid as a single dose, also known as an initial loading dose. Your doctor will do a blood test after this to see how it’s worked for you and then recommend a daily dose to suit. This is usually 62.5micrograms to 250micrograms a day for adults and children over 10 years[1]. 

Always follow the dosage on the label or as prescribed by your doctor or pharmacist.

Can you stop taking digoxin suddenly?

You should not stop taking digoxin suddenly without medical advice. Stopping the medication abruptly can cause your heart condition to worsen. If you need to stop taking digoxin for any reason, your doctor will advise you on how to do so safely[1]. 

What should you do if you take too much digoxin?

Taking too much digoxin can be dangerous. The symptoms of an overdose may include[1]: 

• Nausea and vomiting 

• Loss of appetite 

• Dizziness 

• Feeling very tired or unwell 

• Changes in vision such as blurred vision 

Your doctor may wish to do a blood test to check how much digoxin is in your blood and check how your kidneys are functioning, as well as an electrocardiogram to see the impact on your heartbeat[1]. 

If you think you or someone else has taken more than the prescribed dose of digoxin, call 999 or go to A&E immediately. 

What should you do if you forget a dose of digoxin?

If you remember to take a dose of digoxin shortly after it was due, you can take it. However, if it’s nearly time for your next dose, skip the missed one. Never take two doses of digoxin at the same time[1]. 

What medicines should you avoid while taking digoxin?

Certain medicines and supplements can interact with digoxin and either reduce its effectiveness or increase the risk of side effects. These include drugs and remedies such as[1]: 

• Amiodarone, beta-blockers, verapamil, and diltiazem, which may slow the heart rate too much 

• Some blood pressure medications  

• Diuretics such as furosemide or spironolactone, and other medicines that can affect potassium levels 

• Certain antibiotics  

• Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen 

• Herbal remedies like St John’s Wort 

• HIV medication 

• Antifungal medication 

• Arthritis medication 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of digoxin?

Some of the most common side effects experienced when taking digoxin include[1]: 

• Feeling sick or vomiting 

• Diarrhoea 

• Dizziness  

• Blurred vision 

• Skin rashes  

• An abnormal heartbeat 

Serious side effects are rare but may include[1]: 

• A fast heart rate (palpitations) 

• Shortness of breath 

• Severe dizziness or light-headedness 

• A serious allergic reaction to digoxin, which can present as a severe rash, swelling of the face and throat, and difficulty breathing 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1].

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about digoxin

Can I drink alcohol while taking digoxin? 

It is best to avoid alcohol when you first start taking digoxin until you know how the medicine affects you. Avoiding excessive drinking will help minimise any potential side effects or unwanted symptoms[1]. 

Can I drive while taking digoxin? 

You can drive whilst taking digoxin if you feel well in yourself to do so. If you experience any dizziness or vision problems, you should avoid driving until these symptoms pass. Speak to your doctor if you experience these symptoms regularly[1]. 

Will I need regular blood tests while taking digoxin? 

Yes, you’ll need blood tests to monitor the level of digoxin in your blood and to check your kidney function. This is important for your long-term health[1]. 

Is digoxin safe to take long term? 

Digoxin can be taken safely for a long time. You will be regularly monitored by your doctor to make sure your body and condition are responding well to the treatment, and your dose will be adjusted accordingly[1].

For the official NHS guide to digoxin, visit their website.