Lanoxin Pediatric, Lanoxin

Introduction

Written by Patricia Weiser, PharmD
Medically reviewed by Alex Brewer, PharmD, MBA
Updated on September 7, 2023

Digoxin (di JOKS in) is a generic medication prescribed for heart failure and atrial fibrillation (AFib). Digoxin belongs to a group of drugs called antiarrhythmics.

The Food and Drug Administration (FDA) has approved digoxin to:

• manage heart rhythm in adults with chronic (long-term) AFib, a condition affecting the heart’s electrical signals
• treat mild to moderate heart failure in adults
• improve heart muscle contractions by increasing the blood-pumping capacity in some children with heart failure

Interactions and warnings for digoxin

Below you’ll find information about digoxin’s possible interactions and warnings.

Interactions of digoxin

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take digoxin, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for digoxin” section below.

Warnings for digoxin

Some people should not take digoxin, and others should take it cautiously.

Digoxin could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether digoxin is a safe option for you.

Ask your doctor about specific warnings for digoxin, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Digoxin can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to digoxin or any of its ingredients, your doctor will likely not prescribe digoxin. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to digoxin, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of digoxin

You should not take more digoxin than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much digoxin, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and digoxin

Information about digoxin and pregnancy and breastfeeding is described below.

Digoxin and pregnancy

There are risks to taking digoxin during pregnancy. But there are also risks with having untreated heart failure or atrial fibrillation (AFib) while pregnant. (Keep in mind that digoxin is used for treating heart failure or AFib.)

If you’re planning a pregnancy or can become pregnant, talk with your doctor about heart failure or AFib treatment options during pregnancy. Together, you can discuss the risks and benefits of your treatment options and decide whether or not you should take digoxin during pregnancy.

Digoxin and breastfeeding

It’s not known whether digoxin should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.

Side effects of digoxin

Digoxin may cause mild or serious side effects. More common mild side effects of digoxin and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about digoxin’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for digoxin listed in the “Resources” section.

Mild side effects

More common mild side effects reported with some forms of digoxin are listed below. These side effects may differ based on the form of digoxin you take.

This article doesn’t include all possible mild side effects of the drug. To learn more about digoxin’s side effects based on the form, refer to the prescribing information for digoxin listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Digoxin oral tablet’s and digoxin injection’s (given into the vein or muscle) mild side effects include:

• dizziness
• headaches
• pain in your abdomen
• gynecomastia (atypical growth of breast tissue in males*)
• mild allergic reaction†

*  Sex and gender exist on spectrums. In this article, we use the term “male” to refer to a person’s assigned sex at birth.
† For details about this side effect, see the “Interactions and warnings for digoxin” section.

Serious side effects

Serious side effects of digoxin are listed below.  

This article doesn’t include all possible serious side effects of the drug. To learn more about digoxin’s side effects based on the form, refer to the prescribing information for digoxin listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, digoxin’s serious side effects include:

• slow, rapid, or irregular heart rate
• heart block (a disturbance in the electrical signals that regulate heartbeat)
• vision changes, including blurred vision, halo effects, or vision with a yellowish-green hue
• mood changes, such as depression and anxiety
• mental status changes, such as confusion, hallucinations (seeing or hearing things that aren’t real), and delirium (a severe, sudden change in brain function that causes confusion and inability to think clearly)
• gastrointestinal changes, such as persistent diarrhea or intestinal damage
• low platelet levels
• severe allergic reaction*

* For details about this side effect, see the “Interactions and warnings for digoxin” section.

Common questions about digoxin

Below you’ll find answers to a few commonly asked questions about digoxin.

What is digoxin’s mechanism of action? How does the drug work?

Digoxin works by blocking certain pumps that regulate the flow of electrolytes in and out of cells. This increases the amount of calcium that enters heart muscle and nerve cells.

These effects result in the heart contracting harder, making it pump blood more efficiently. Digoxin also slows heart rate by decreasing certain electrical signals in the heart. And it reduces the activation of particular pathways in the nervous system and body that can stress the heart.

Taken orally, a dose of digoxin starts working within 30 minutes to 2 hours. It takes 2–6 hours to reach its full effects. Given intravenously (into a vein) or as an injection into a muscle, a dose of digoxin starts working within 5– 30 minutes. This form of the drug reaches its full effects within 1–4 hours.

It takes 1–2 weeks before your blood level of digoxin reaches the goal range for your condition. Your doctor may order blood tests to check your digoxin level and make any necessary dosage adjustments.

If you’d like to know more about how digoxin works, talk with your doctor or pharmacist.

Do I need to take digoxin at night?

Not necessarily. Digoxin is usually taken once a day. There isn’t a best time of day to take digoxin. But you should take your dose at the same time each day. Doing so keeps a steady level of the drug in your body. This helps the drug work effectively to treat your condition.

Talk with your doctor or pharmacist if you have questions about your dosing schedule for digoxin.

Does digoxin affect blood pressure?

Not typically. Digoxin lowers heart rate, but generally doesn’t affect a person’s blood pressure.

In some cases, doctors may prescribe digoxin together with blood pressure medications to treat heart failure. Examples of these blood pressure medications are:

• diuretics (“water pills”), such as chlorthalidone
• angiotensin converting enzyme (ACE) inhibitors, such as lisinopril

If you have questions about digoxin and blood pressure, talk with your doctor.

Uses of digoxin

The Food and Drug Administration (FDA) approves prescription drugs such as digoxin for certain conditions. Approved uses for digoxin are described below. These uses differ based on the form of digoxin prescribed.

Use for heart failure

Doctors may prescribe digoxin oral tablet, oral liquid solution, or injection (given into the vein or muscle) for treating heart failure. It’s used for this purpose in adults and children of any age. It’s usually prescribed as a long-term treatment.

With heart failure, your heart can’t pump blood very well. This results in less blood and oxygen reaching your organs and tissues.

Doctors may prescribe digoxin together with other medications for heart failure. These may include a diuretic (“water pill”) and an angiotensin converting enzyme (ACE) inhibitor, such as lisinopril.

Use for atrial fibrillation

Doctors may prescribe digoxin oral tablet, oral liquid solution, or injection (given into the vein or muscle) for treating atrial fibrillation (AFib). It’s used for this purpose in adults. It’s usually prescribed as a long-term treatment.

With AFib, the electrical signals in the heart are irregular, causing different parts to contract at different rates. This can cause blood flow problems and increase the risk of blood clots.

What to ask your doctor

Let your doctor know if you have questions about digoxin or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Am I at higher risk of side effects from digoxin than others?
• How long will I need to take digoxin?
• How often will I need to get blood tests while taking digoxin?
• What should I do if I vomit after taking a dose of digoxin?

Resources

• Digoxin injection. (2020). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/9b9a4b3c-5f08-475a-a74d-0c7ebba40644/spl-doc
• Digoxin oral solution. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/ce62a741-a981-4880-8ce3-93269606a730/spl-doc
• Digoxin tablets, for oral use. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/8ae4022d-ec54-4457-9d67-59a493a17476/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.