š Medicine Name
Digoxin Tablet 0.25 mg
(Also known as digitalis; derived from the Digitalis lanata plant)
š Description / Prescription
- Type: Cardiac glycoside
- Form: Oral tablet
- Strength: 0.25 mg (250 micrograms)
- Prescription: ā Required
- Schedule: Often Schedule H (in India) or Rx-only (globally)
- Used for:
- Heart failure (especially with reduced ejection fraction)
- Atrial fibrillation and atrial flutter (for rate control)
š¬ Nature / Mechanism of Action
Digoxin increases the force of myocardial contractions and slows conduction through the atrioventricular (AV) node.
- Inhibits sodium-potassium ATPase pump ā ā intracellular sodium ā ā calcium in heart cells ā stronger contraction (positive inotropic effect)
- Enhances vagal tone ā slows AV node conduction ā helps control heart rate in AF/flutter
Onset of Action (oral): ~1ā2 hours
Half-life: 36ā48 hours (longer in elderly or kidney disease)
Narrow therapeutic index ā requires blood level monitoring
ā Advantages / Benefits
- ā Improves cardiac output in heart failure
- ā Helps control ventricular rate in atrial fibrillation
- ā Especially helpful in patients with heart failure and AF
- ā Once-daily dosing due to long half-life
- ā Reduces hospitalization for heart failure
- ā Available as oral and injectable forms
š¦ Packaging
- Commonly available in blister strips or plastic bottles
- Each tablet contains 0.25 mg of digoxin
- Available pack sizes: 10, 30, 100 tablets
- Tablets are usually small, round, and white or yellow in color
- May be scored for dose adjustment
š”ļø Storage Conditions
- Store at 15Ā°Cā25Ā°C (59Ā°Fā77Ā°F)
- Protect from light and moisture
- Keep in original container
- Keep out of reach of children
ā ļø Precautions / Contraindications
ā Do NOT use in:
- Ventricular fibrillation
- Hypersensitivity to digoxin or digitalis
- Advanced AV block without pacemaker
- Digoxin toxicity history
ā ļø Use with caution in:
- Elderly patients (increased toxicity risk)
- Renal impairment (renally excreted ā dose must be adjusted)
- Electrolyte imbalances:
- Hypokalemia
- Hypercalcemia
- Hypomagnesemia
- Thyroid disorders (affect digoxin metabolism)
- Use with interacting drugs: diuretics, amiodarone, verapamil, quinidine, erythromycin, etc.
š©āāļø Patient Advice / Counseling Points
ā How to Take:
- Take once daily, at the same time each day
- Can be taken with or without food
- Do not skip or double dose
- If a dose is missed, take it as soon as possible unless it’s close to the next dose
ā What to Avoid:
- Avoid antacids, kaolin-pectin, cholestyramine within 2 hours of digoxin (reduces absorption)
- Avoid over-the-counter herbal products without doctor approval
- Avoid abrupt discontinuation
ā Monitor for Side Effects / Toxicity:
- Nausea, vomiting, loss of appetite
- Visual changes (yellow or blurred vision)
- Confusion, dizziness
- Irregular or slow heartbeat