Digoxin should not be used for the treatment of multifocal atrial tachycardia. Do not use digoxin after the expiry date on carton, bottle label, or blister pack (Exp.). You'll need regular blood tests while taking digoxin to check that your kidneys are healthy and you have the right amount of potassium, magnesium and calcium in your blood. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product. 2023 Kaiser Foundation Health Plan, Inc. We are unable to switch you to this area of care. If you stop taking digoxin, it will take about 8 days for it to be completely out of your body. vandetanib (used to treat certain cancers of the thyroid gland). Selecting these links will take you away from KP.org. Available for Android and iOS devices. Accordingly, ultimate dosage selection must be based upon clinical assessment of the patient. Heart Failure: Digoxin is indicated for the control of ventricular response rate in patients with chronic atrial fibrillation. This is because older people may have reduced kidney function. What you need to know before you use Digoxin tablets, If you use more Digoxin tablets than you should, What Digoxin tablets looks like and contents of the pack, Marketing Authorisation Holder and Manufacturer, Service-Tel: 0800 008 7392 (+44 1748 828 391). It is used most often when treating arrhythmias or acute heart failure. We comply with the HONcode standard for trustworthy health information. Use this medication regularly to get the most benefit from it. Heart Failure: If you are also taking cholestyramine, colestipol, or psyllium, wait at least 2 hours after taking your digoxin dose before taking any of these products. If you're using the liquid, it's important to measure your dose using the syringe (pipette) that comes with the medicine. Other medications can affect the removal of digoxin from your body, which may affect how digoxin works. Chronic Heart Failure: The Digitalis Investigation Group (DIG) main trial was a multicenter, randomized, double-blind, placebo-controlled mortality study of 6801 patients with heart failure and left ventricular ejection fraction 0.45. Tell your doctor right away if you have any serious side effects, including: Though this medication is used to treat a certain type of irregular heartbeat, it may rarely cause other types of irregular heartbeats. Page last reviewed: 22 March 2023 Discuss the risks and benefits with your doctor. colestyramine (lowers blood cholesterol). Do not take 2 doses to make up for a forgotten dose. Use OR to account for alternate terms Digoxin is used to treat heart failure, usually along with other medications. DIGITEK (digoxin tablets, USP) is available containing 125 mcg (0.125 mg) or 250 mcg (0.25 mg) of digoxin, USP. Other symptoms of digoxin toxicity include dizziness, fatigue, a general feeling of being unwell and various neurological disturbances including visual disturbances (more yellow-green than usual). What Digoxin tablets is and what it is used for, 2. The results published in 1997 revealed that after 3 years of follow up, when digoxin was added to an ACEi-based protocol for symptomatic congestive heart failure and sinus rhythm with left ventricular ejection fraction below 45%, there was no statistically significant mortality differences between treatment and control group but hospitalization . 0.125 mg twice daily or 0.25 mg once daily. salbutamol (a product used to treat asthma). In the smaller trial, these trended in favor of a treatment benefit. It can take several weeks for digoxin to start working. Side effects of digoxin treatment affecting the mother may also affect the unborn child. The dosage of this medication is based on your medical condition, age, body weight, laboratory tests, and response to treatment. Administration of Potassium: Manifestations of life-threatening toxicity include ventricular tachycardia or ventricular fibrillation, or progressive bradyarrhythmias, or heart block. o [ abdominal pain pediatric ] Your doctor will tell you how long you should take digoxin. A hypersensitivity reaction to other digitalis preparations usually constitutes a contraindication to digoxin. Doses should be calculated based upon lean (i.e., ideal) body weight. You can also report side effects directly via the Yellow Card Scheme. Some conditions may become worse when the drug is suddenly stopped. If you develop digoxin toxicity, this can lead to various forms of heart rhythm disturbances, some of which resemble the rhythm disturbances for which the product was prescribed. Gastrointestinal symptoms include loss of appetite, nausea and vomiting. Each tablet contains the labeled amount of digoxin USP and the following inactive ingredients: 0.250 mg - colloidal silicon dioxide, croscarmellose sodium, lactose anhydrous, magnesium stearate, microcrystalline cellulose, stearic acid. nifedipine, diltiazem, angiotensin receptor blockers (ARBs) and ACE inhibitors (used to treat high blood pressure and congestive heart failure). Tell your doctor right away if you notice any unusually fast/slow/irregular heartbeat. Nevertheless, caution should be exercised when digoxin is administered to a nursing woman. This makes it easier for the heart to pump blood around your body which helps your heart work better. It's important to take it as your doctor has recommended. Rarely, there are patients who are unable to tolerate digoxin at serum concentrations below 0.8 ng/mL. More gradual digitalization may be obtained by beginning an appropriate maintenance dose, thus allowing digoxin body stores to accumulate slowly. Conditions (described in and ) causing an alteration in the sensitivity of the patient to digoxin. Hypothyroidism may reduce the requirements for digoxin. Treatment of Adverse Reactions Produced by Overdosage: Rapid Digitalization with a Loading Dose: with careful assessment of clinical response before each additional dose. Digoxin is a type of medicine called a cardiac glycoside and it's the only medicine of its kind. Can lifestyle changes help with heart problems? Consequently, the serum concentration of digoxin should always be interpreted in the overall clinical context, and an isolated measurement should not be used alone as the basis for increasing or decreasing the dose of the drug. If you are taking diuretics (drugs which promote urine production and help reduce the amount of water in your body) with or without an ACE inhibitor (mainly used to treat high blood pressure), your doctor will prescribe a lower dose of digoxin. If a patient presents more than 2 hours after ingestion or already has toxic manifestations, it may be unsafe to induce vomiting or attempt passage of a gastric tube, because such maneuvers may induce an acute vagal episode that can worsen digitalis-related arrhythmias. 20-35. If you have a sinoatrial disorder (a disorder in the conduction of electrical impulses in the heart such as Sick Sinus Syndrome), in some patients with a sinoatrial disorder this medicine can cause a slow and/or irregular heart-beat. CONTRAINDICATIONS Maintenance Dosing: In a subset of approximately 1800 patients enrolled in the DIG trial (wherein dosing was based on an algorithm similar to that in Table 5) the mean ( SD) serum digoxin concentrations at 1 month and 12 months were 1.01 0.47 ng/mL and 0.97 0.43 ng/mL, respectively. DIGIBIND is a specific antidote for digoxin and may be used to reverse potentially life-threatening ventricular arrhythmias due to digoxin overdosage. Although the effect on all-cause death or hospitalization was not statistically significant, much of the apparent benefit derived from effects on mortality and hospitalization attributed to heart failure. Therapeutics Digoxin is used for the treatment of congestive heart failure and of atrial fibrillation. Each tablet contains the labeled amount of digoxin USP and the following inactive ingredients: 0.250 mg - colloidal silicon dioxide, croscarmellose sodium, lactose anhydrous, magnesium stearate, microcrystalline cellulose, stearic acid. Accordingly, ultimate dosage selection must be based upon clinical assessment of the patient. Some types of hormonal contraception, such as the combined pill and contraceptive patch, are not usually recommended for women with heart problems. Do not stop taking digoxin without talking to your doctor. If digoxin makes you vomit or have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Keep out of the reach and sight of children. See section 4. Additional doses of 125 to 375 mcg (0.125 to 0.375 mg) may be given cautiously at 6 to 8-hour intervals until clinical evidence of an adequate effect is noted. If you have Beri-beri disease (caused by a vitamin B1 deficiency). some bulk-forming laxatives (increase the amount of stools you produce to help you have bowel movements). Your medication may look different. You'll usually need to take digoxin long term, even for the rest of your life. Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. Digitalis glycosides can cause poisoning in children due to accidental ingestion. Severity: Severe. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Although inactivation of these bacteria by antibiotics is rapid, the serum digoxin concentration will rise at a rate consistent with the elimination half-life of digoxin. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Example: Based on Table 5, a patient in heart failure with an estimated lean body weight of 70 kg and a Ccr of 60 mL/min should be given a dose of 250 mcg (0.25 mg) daily of digoxin tablets, usually taken after the morning meal. Can I drink alcohol while taking digoxin? Doses may be increased every 2 weeks according to clinical response. The peak height and slope of the early portion (absorption/distribution phases) of the serum concentration-time curve are dependent upon the route of administration and the absorption characteristics of the formulation. Only a small percentage (16%) of a dose of digoxin is metabolized. Special Populations: The clearance of digoxin can be primarily correlated with renal function as indicated by creatinine clearance. As mentioned above, this calculator uses the Bauman-DiDomenico nomogram for dosing heart failure patients (without arrhythmias). Before taking digoxin, tell your doctor or pharmacist if you are allergic to it; or to similar drugs (such as digitoxin); or if you have any other allergies. Talk to your doctor if you want to stop taking it. However, digoxin may produce clinical benefits even at serum concentrations below this range. Severe digitalis intoxication can cause a massive shift of potassium from inside to outside the cell, leading to life-threatening hyperkalemia. The loading dose should be administered in several portions, with roughly half the total given as the first dose. Medicines should not be disposed of via wastewater or household waste. The pharmacologic consequences of these direct and indirect effects are: (1) an increase in the force and velocity of myocardial systolic contraction (positive inotropic action); (2) a decrease in the degree of activation of the sympathetic nervous system and renin-angiotensin system (neurohormonal deactivating effect); and (3) slowing of the heart rate and decreased conduction velocity through the AV node (vagomimetic effect). It's sometimes prescribed for children if a heart specialist recommends it. dronedarone (used to treat irregular heart-beat). Contents of the pack and other information. Steady-state serum digoxin concentrations will be achieved in approximately five half-lives of the drug for the individual patient. US residents can call their local poison control center at 1-800-222-1222. This reduces strain on the heart and helps it maintain a normal, steady, and strong heartbeat. Alcohol or marijuana (cannabis) can make you more dizzy. The patients renal function, preferably evaluated on the basis of estimated creatinine clearance. Do not pass it on to others. The following formula has had wide clinical use: Maintenance Dose = Peak Body Stores (i.e., Loading Dose) x % Daily Loss/100 Where: % Daily Loss = 14 + Ccr/5, (Ccr is creatinine clearance, corrected to 70 kg body weight or 1.73 m body surface area.) A digitalizing dose is now used infrequently. The tour begins on Aug. 3 in Sterling . If rapid digitalization is considered medically appropriate, it may be achieved by administering a loading dose based upon projected peak digoxin body stores. When will I feel better? indomethacin (used to treat inflammation). If the rhythm disturbance is a symptomatic bradyarrhythmia or heart block, consideration should be given to the reversal of toxicity with DIGIBIND [Digoxin Immune Fab (Ovine)] (see Massive Digitalis Overdosage subsection), the use of atropine, or the insertion of a temporary cardiac pacemaker. antacids (used to treat gastric acidity). 2. GOV.UK has more information on the law on drugs and driving. Last updated on Oct 17, 2022. Continued treatment with digoxin reduced the risk of developing worsening heart failure, as evidenced by heart failure-related hospitalizations and emergency care and the need for concomitant heart failure therapy. A digitalizing dose is now used infrequently. However, this drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Care must be taken to avoid toxicity if digoxin is used. Following oral administration, peak serum concentrations of digoxin occur at 1 to 3 hours. The loading dose should be administered in several portions, with roughly half the total given as the first dose. Table 5: Usual Daily Maintenance Dose Requirements (mcg) of Digoxin for Estimated Peak Body Stores of 10 mcg/kg, Table 6: Daily Maintenance Doses in Children with Normal Renal Function. The end metabolites, which include 3 -digoxigenin, 3-keto-digoxigenin, and their glucuronide and sulfate conjugates, are polar in nature and are postulated to be formed via hydrolysis, oxidation, and conjugation. Use During Electrical Cardioversion: Patients receiving digoxin should have their serum electrolytes and renal function (serum creatinine concentrations) assessed periodically; the frequency of assessments will depend on the clinical setting. The 125 mcg (0.125 mg) tablets are yellow, round, scored, slope-faced tablets debossed with M above the score and 145 below the score on one side of the tablet and blank on the other side. Use of digoxin was associated with a trend to increase time to all-cause death or hospitalization. Rather, the earliest and most frequent manifestation of excessive dosing with digoxin in infants and children is the appearance of cardiac arrhythmias, including sinus bradycardia. If patients are switched from intravenous to oral digoxin formulations, allowances must be made for differences in bioavailability when calculating maintenance dosages (see Table 1, ). For women, this result should be multiplied by 0.85. It's used to control some heart problems, such as irregular heartbeats (arrhythmias) including atrial fibrillation.It can also help to manage the symptoms of heart failure, usually with other medicines.It's normally recommended when these other medicines have not been enough to control your symptoms on their own. DOSAGE AND ADMINISTRATION. It works by slowing your heart rate down and improving the way your ventricles are filled with blood. Concomitant use of digoxin and increases the risk of cardiac arrhythmias. Sinus Node Disease and AV Block: After intravenous digoxin therapy, some patients with paroxysmal atrial fibrillation or flutter and a coexisting accessory AV pathway have developed increased antegrade conduction across the accessory pathway bypassing the Av node, leading to a very rapid ventricular response or ventricular fibrillation. Excretion: Race differences in digoxin pharmacokinetics have not been formally studied. Treating heart failure may help maintain your ability to walk and exercise and may improve the strength of your heart. The dose of digoxin is important as too little will not help, but too much can cause side effects. Table 5 provides average daily maintenance dose requirements of digoxin tablets for patients with heart failure based upon lean body weight and renal function: Ccr is creatinine clearance, corrected to 70 kg body weight or 1.73 m body surface area. These include: The following medicines increase the level of digoxin in the blood, which can increase the risk of toxicity: The following medicines may increase or have no effect on the levels of digoxin in the blood: If you have heart failure and are taking sennosides (increase the amount of stools you produce to help you have bowel movements) along with digoxin you may have a moderately increased risk of digoxin toxicity. About two-thirds of adults considered adequately digitalized (without evidence of toxicity) have serum digoxin concentrations ranging from 0.8 to 2.0 ng/mL. metoclopramide (a product for treating nausea and vomiting). However, the maintenance dose is usually 3 to 4.5 mcg per kg of body weight per day. A 45-year-old woman who feared she'd never become a mum welcomed a "miracle" baby - after inserting Viagra to fall pregnant. On the other hand, hypocalcemia can nullify the effects of digoxin in humans; thus, digoxin may be ineffective until serum calcium is restored to normal. If you have questions, ask your pharmacist. sulfasalazine (a product to counteract inflammatory diseases of the intestine). Use in Thyroid Disorders and Hypermetabolic States: Digoxin should be used with caution in patients with acute myocardial infarction. Will I need to stop digoxin before surgery? Digoxin is also used to treat atrial fibrillation, a heart rhythm disorder of the atria (the upper chambers of the heart that allow blood to flow into the heart). Potassium is usually administered orally, but when correction of the arrhythmia is urgent and the serum potassium concentration is low, potassium may be administered cautiously by the intravenous route. You'll usually take it once a day. Chronic Atrial Fibrillation: Digoxin is indicated for the treatment of mild to moderate heart failure. Talk to your doctor if you want to stop taking digoxin. Digoxin is a very effective medicine, but it can have serious side effects. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, which should be based on renal function, and it may be useful to monitor renal function (see ). In selecting a dose of digoxin, the following factors must be considered: Serum Digoxin Concentrations: In general, the dose of digoxin used should be determined on clinical grounds. CLINICAL PHARMACOLOGY. If you have any side effects or concerns, speak to your doctor. Your doctor may adjust your dose as needed. Talk to your doctor, pharmacist or nurse before using this medicine: Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. 3016 Lake Drive, Citywest Business Campus, Dublin 24, Ireland. Your doctor will check your dose is right and you'll be asked to have blood tests. Heart failure and/or atrial arrhythmias resulting from hypermetabolic or hyperdynamic states (e.g., hyperthyroidism, hypoxia, or arteriovenous shunt) are best treated by addressing the underlying condition. Digoxin is used to treat heart failure. If the rhythm disturbance is a ventricular arrhythmia, consideration should be given to the correction of electrolyte disorders, particularly if hypokalemia (see Administration of Potassium subsection) or hypomagnesemia is present. Therefore, this medicine can be used by women who are breast-feeding. Sometimes this will cause tiredness, weakness and dizziness and when your heartbeat is very slow you may faint. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Doses should be calculated based upon lean (i.e., ideal) body weight. Your doctor will have decided how much of this medicine is right for you: You usually take this medicine in two stages: The loading dose gets your digoxin levels up to the correct level quickly. Applies to the following strengths: 250 mcg/mL (0.25 mg/mL); 50 mcg/mL (0.05 mg/mL); 100 mcg/mL (0.1 mg/mL); 125 mcg (0.125 mg); 250 mcg (0.25 mg); 500 mcg (0.5 mg); 50 mcg (0.05 mg); 100 mcg (0.1 mg); 200 mcg (0.2 mg); 62.5 mcg (0.0625 mg); 187.5 mcg (0.1875 mg) Usual Adult Dose for: Atrial Fibrillation > 10 years or weight >30 kg. some cytostatic drugs (used as chemotherapy for cancer treatment). The first time you take digoxin you may be asked to take several tablets (or amounts of liquid) as a single dose this is called the initial dose. 0800 198 5000. Digoxin produces PR prolongation and ST segment depression which should not by themselves be considered digoxin toxicity. , if only serum creatinine concentrations (Scr) are available, a Ccr (corrected to 70 kg body weight) may be estimated in men as (140 - Age)/Scr. Drug toxicity: Serum levels of this drug just before the next scheduled dose or at least 6 hours after the last dose. Your doctor may prescribe you a different medicine. amlodipine, lisinopril, metoprolol, furosemide, carvedilol, spironolactone, propranolol, diltiazem, Xarelto, digoxin. 6-10 years. Digoxin may cause anorexia, nausea, vomiting, and diarrhea. Your doctor may be able to prescribe a different medicine for your heart problems. Digoxin tablets contains the active substance digoxin, which belongs to a group of medicines called cardiac glycosides. Such disorders include restrictive cardiomyopathy, constrictive pericarditis, amyloid heart disease, and acute cor pulmonale. Atrial Fibrillation: The difference in bio-availability between Digoxin Injection or Digoxin Solution in Capsules and Digoxin Elixir Pediatric or Digoxin Tablets must be considered when changing patients from one dosage form to another. The treatment of paroxysmal supraventricular tachycardia in such patients is usually direct-current cardioversion. Data are not available to establish the appropriate resting or exercise target rates that should be achieved. Children over 10 years of age require adult dosages in proportion to their body weight. CLINICAL PHARMACOLOGY: Pharmacokinetics, NDC:68151-1603-0 in a PACKAGE of 1 TABLETS, Set id: c8c7482e-6276-4ec6-a7b9-365ab73bb99b, DIGOX (Digoxin Tablets, USP) 125 mcg (0.125 mg) 250 mcg (0.25 mg), Table 1: Comparisons of the Systemic Availability and Equivalent Doses for Oral Preparations of Digoxin, Equivalent Doses (mcg) Among Dosage Forms, Table 2: Times to Onset of Pharmacologic Effect and to Peak Effect of Preparations of Digoxin, Table 3: Subgroup Analyses of Mortality and Hospitalization During the First Two Years Following Randomization, Riskof All-Cause Mortality or All-Cause Hospitalization, Risk of HF-Related Mortality or HF-Related Hospitalization. Once the adverse reaction has resolved, therapy with digoxin may be reinstituted, following a careful reassessment of dose. Serum Digoxin Concentrations: To allow adequate time for equilibration of digoxin between serum and tissue, sampling of serum concentrations should be done just before the next scheduled dose of the drug. In this trial, the most common manifestations of digoxin toxicity included gastrointestinal and cardiac disturbances; CNS manifestations were less common. In chronic toxicity, non-heart related symptoms, such as weakness and a general feeling of being unwell, may be the main symptoms. Examples include azole antifungals (such as itraconazole), dronedarone, lapatinib, macrolide antibiotics (such as clarithromycin, erythromycin), propafenone, St. John's wort, among others. 5. Use for phrases Keep all medical and lab appointments. While you are taking this medicine, your doctor will take regular blood tests. If you are taking antacids, kaolin-pectin, milk of magnesia, metoclopramide, sulfasalazine, or aminosalicylic acid, take them as far apart from your digoxin dose as possible. If patients are switched from intravenous to oral digoxin formulations, allowances must be made for differences in bioavailability when calculating maintenance dosages (see Table 1, CLINICAL PHARMACOLOGY). About two-thirds of adults considered adequately digitalized (without evidence of toxicity) have serum digoxin concentrations ranging from 0.8 to 2.0 ng/mL. Do not stop your treatment early without consulting your doctor. Peak digoxin body stores larger than the 8 to 12 mcg/kg required for most patients with heart failure and normal sinus rhythm have been used for control of ventricular rate in patients with atrial fibrillation. These electrophysiologic effects reflect an expected effect of the drug and are not indicative of toxicity. Before having surgery or certain procedures on your heart (such as electrical cardioversion), tell your doctor or dentist that you are using this medication. may decrease serum digoxin concentration, especially in patients with renal dysfunction, by increasing the non-renal clearance of digoxin. 250 mcg (0.25 mg) doses of Digoxin Tablets and Elixir Pediatric, respectively (see Table 1 in CLINICAL PHARMACOLOGY: Pharmacokinetics). Digoxin is supplied as 125 mcg (0.125 mg) or 250 mcg (0.25 mg) tablets for oral administration. The amount of digoxin that can lead to an overdose varies from person to person. Digoxin was associated with a 25% reduction in the number of hospitalizations for heart failure, a 28% reduction in the risk of a patient having at least one hospitalization for heart failure, and a 6.5% reduction in total hospitalizations (for any cause). Canada residents can call a provincial poison control center. Do not use a household spoon because you may not get the correct dose. Any arrhythmia or alteration in cardiac conduction that develops in a child taking digoxin should be assumed to be caused by digoxin, until further evaluation proves otherwise. x % Daily Loss/100 Digoxin will not affect any type of contraception. It can take several weeks for digoxin to start working and you will not feel better straight away. The Cockcroft and Gault formula for estimation of creatinine clearance includes age, body weight, and gender. Premature: IV: 15 to 25 mcg/kg; Oral solution: 20 to 30 mcg/kg, Full-term: IV: 20 to 30 mcg/kg; Oral solution: 25 to 35 mcg/kg, One month to 2 years: IV: 30 to 50 mcg/kg; Oral solution: 35 to 60 mcg/kg, Two to five years: IV: 25 to 35 mcg/kg; Oral solution: 30 to 45 mcg/kg, Five to ten years: IV: 15 to 30 mcg/kg; Oral solution: 20 to 35 mcg/kg; Tablets: 20 to 45 mcg/kg, Greater than 10 to less than 18 years: IV: 8 to 12 mcg/kg; Oral solution: 10 to 15 mcg/kg; Tablets: 10 to 15 mcg/kg, Premature: IV: 1.9 to 3.1 mcg/kg twice a day; Oral solution: 2.3 to 3.9 mcg/kg twice a day, Full-term: IV: 3 to 4.5 mcg/kg twice a day; Oral solution: 3.8 to 5.6 mcg/kg twice a day, One month to 2 years: IV: 4.5 to 7.5 mcg/kg twice a day; Oral solution: 5.6 to 9.4 mcg/kg twice a day, Two to five years: IV: 3.8 to 5.3 mcg/kg twice a day; Oral solution: 4.7 to 6.6 mcg/kg twice a day, Five to ten years: IV: 2.3 to 4.5 mcg/kg twice a day; Oral solution: 2.8 to 5.6 mcg/kg twice a day; Tablets: 3.2 to 6.4 mcg/kg twice a day, Greater than 10 to less than 18 years: IV: 2.4 to 3.6 mcg/kg once a day; Oral solution: 3 to 4.5 mcg/kg once a day; Tablets: 3.4 to 5.1 mcg/kg once a day. Children over 10 years of age require adult dosages in proportion to their body weight. Also, advanced age may be indicative of diminished renal function even in patients with normal serum creatinine concentration (i.e., below 1.5 mg/dL). 0.125 mg - colloidal silicon dioxide, croscarmellose sodium, D&C yellow aluminum lake #10, lactose anhydrous, magnesium stearate, microcrystalline cellulose, stearic acid. Tell your doctor if your condition does not improve or if it worsens. Doses of 100 mcg (0.1 mg) and 200 mcg (0.2 mg) of Digoxin Solution in Capsules are approximately equivalent to 125 mcg (0.125 mg) and For discussion of serum digoxin concentrations, see section. If you have atrial fibrillation, or certain heart problems such as arrhythmia, you may notice improvements after a few weeks. Not all photos of the drug may be displayed. Properly discard this product when it is expired or no longer needed. In situations where there is no statistically significant benefit of treatment evident from a trials primary endpoint, results pertaining to a secondary endpoint should be interpreted cautiously. Consult your doctor for more details. Control of ventricular response rate in patients with chronic atrial fibrillation. Studies have shown that digoxin concentrations in the mothers serum and milk are similar. The administration of potassium supplements in the setting of massive intoxication may be hazardous and should be avoided. If you miss a dose, take it as soon as you remember if it is within 12 hours of your scheduled dose. Clinical evidence indicates that the early high serum concentrations do not reflect the concentration of digoxin at its site of action, but that with chronic use, the steady-state post-distribution serum concentrations are in equilibrium with tissue concentrations and correlate with pharmacologic effects. 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