Digoxin is indicated in:
- Heart failure
- Atrial fibrillation with an uncontrolled ventricular rate
- Acute left ventricular failure
- Chronic left ventricular failure and congestive heart failure, especially when caused by hypertensive valvular (especially mitral valvular) disease or ischaemic heart disease.
Dosage & Administration
For rapid action: 1 to 1.5 mg in divided doses over 24 hours
For less urgent digitalisation: 0.25 to 0.5 mg daily(higher dose may be divided); Maintenance: 0.0625 to 0.5 mg daily (higher dose may be divided) accordingly to renal function and in atrial fibrilation on heart rate response;
Usual dose: 0.125 to 0.25 mg daily (lower dose my be appropriate in elderly).
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.
Potentially Fatal: Electrolyte imbalances such as hypokalaemia and hypomagnesemia (e.g. admin of potassium-losing diuretics, corticosteroids) can increase the risk of cardiac toxicity.