API

Digoxin

Drug classification

Dosage form

Tablet

API strength per dosage

0.25MG

Dose

Adults: Initial dose 0.75-1.25 mg orally, followed by 0.125-0.5 mg daily based on response and renal function. Pediatrics: Dosing based on age, weight, and clinical condition. Special populations: Reduce dose in elderly and those with renal impairment; monitor serum levels to avoid toxicity.

Mechanism of action

Digoxin inhibits the sodium-potassium ATPase enzyme, increasing intracellular sodium. This reduces sodium-calcium exchange, increasing intracellular calcium, enhancing cardiac contractility and output, and modulating the autonomic nervous system to decrease heart rate.

Indications

Heart failure, atrial fibrillation, atrial flutter, paroxysmal atrial tachycardia.

Side effects

Nausea, vomiting, diarrhea, visual disturbances (blurred or yellow vision), arrhythmias, bradycardia, fatigue, confusion, dizziness, electrolyte imbalances, gynecomastia, thrombocytopenia.

Pregnancy category

Category C

Precautions

Monitor electrolytes (especially potassium, magnesium, calcium), renal function, avoid rapid intravenous administration, adjust dose in renal impairment, caution in elderly, avoid with ventricular fibrillation, use cautiously in hypothyroidism, myocarditis, or acute myocardial infarction, monitor for signs of toxicity, especially in patients with electrolyte imbalances.

Contraindications

Ventricular fibrillation, ventricular tachycardia, hypersensitivity to digoxin, beriberi heart disease, uncorrected electrolyte imbalances (hypokalemia, hypercalcemia), incomplete AV block without pacemaker, acute myocardial infarction.