Digoxin

NHS information about digoxin, including what it's used for, who can use it, how to use it and side effects.

What digoxin is for

Digoxin is a type of medicine called a cardiac glycoside. It helps your heart beat more strongly and can help control the rate it beats at.

It's used to treat:

• some types of heart rhythm problem (arrhythmia), such as atrial fibrillation and atrial flutter
• heart failure

How to take digoxin

Digoxin usually comes as tablets or a liquid you swallow (oral solution).

Most people take it once a day, but how much you need to take and for how long depends on why you're taking it.

You may need a high dose to start with (called a loading dose) and then a lower dose long term (maintenance dose).

Your doctor will explain your dose to you. You'll have regular blood tests to see how your body is responding to the medicine.

When taking digoxin:

• swallow tablets whole with a drink of water
• use the spoon or cup that comes with the liquid medicine to measure the correct dose
• try to take it at the same time each day
• you can take it with or without food

Always check the packet or leaflet that comes with your medicine. Ask a pharmacist or doctor for advice if you're not sure how to take it or have any problems taking it.

Side effects of digoxin

Like all medicines, digoxin can cause side effects, although not everyone gets them.

Possible serious side effects of digoxin can include:

• too much of the medicine building up in your body (toxicity) – causing symptoms such as a fast, slow or unsteady heartbeat, feeling sick (nausea) and being sick (vomiting), loss of appetite, confusion, dizziness, or vision problems such as things looking yellow
• heart rhythm problems (arrhythmias) – causing symptoms such as chest pain, shortness of breath, sweating, or your heart feeling like it's pounding, racing, fluttering or missing a beat (palpitations)
• problems with your blood – this can make you bleed more easily, causing symptoms such as nosebleeds or bruising easily
• an allergic reaction (anaphylaxis) – causing symptoms such as a swollen throat or tongue, a raised, itchy rash and difficulty breathing

If you feel dizzy or have vision problems, do not drive, ride a bike or use tools or machinery until these symptoms have stopped.

More about side effects

These are not all the side effects of digoxin.

For a full list, see the leaflet that comes with your medicine or search for your medicine leaflet on the electronic medicines compendium website.

You can report any side effects you get on the Yellow Card website

Who can and cannot use digoxin

Most adults can take digoxin. It's also sometimes prescribed for children.

But digoxin is not suitable for everyone. For example, it may not be suitable if:

• you have had an allergic reaction or serious side effect from digoxin or a similar medicine before
• you have recently had a heart attack,
• you have a condition that affects your heart muscle (cardiomyopathy), the lining of your heart (myocarditis) or the way your heart beats (such as Wolff-Parkinson-White syndrome)
• you have low levels of potassium or magnesium, or high levels of calcium in your blood
• you have kidney or thyroid problems, or severe lung problems

Before taking digoxin, tell your doctor if you have any other medical conditions.

Breastfeeding and digoxin

Digoxin can be used when breastfeeding.

It's rare for breastfed babies to get any side effects from medicine you're taking, but speak to a healthcare professional or call NHS 111 if you have any concerns about your baby.

Pregnancy and digoxin

Speak to a doctor if you're pregnant or planning to get pregnant.

Digoxin can be used during pregnancy if needed, but your doctor may recommend changing your dose.

Taking digoxin with other medicines, food and drink

There are some medicines, remedies and supplements that may not mix well with digoxin.

This includes:

• some medicines for high blood pressure or heart problems, such as verapamil, felodipine or beta blockers
• steroids
• medicines that make you pee more (diuretics)
• some types of laxative
• some types of antibiotic, such as clarithromycin, erythromycin and azithromycin
• some antifungal medicines, such as itraconazole
• NSAIDs (non-steroidal anti-inflammatory drugs), such as a ibuprofen and aspirin
• medicines for indigestion, such as antacids and proton pump inhibitors like omeprazole
• St John's wort, a herbal remedy

Before taking digoxin, tell your doctor if you're taking any other medicines, herbal remedies, vitamins or supplements.

Food, drink and alcohol with digoxin

You can eat and drink as normal when taking digoxin, but try to limit how much liquorice root you have as it can increase the effects of your medicine.

Foods high in fibre, such as bran, oats or wholewheat pasta, can affect how digoxin works. You can still eat these foods, but ask your doctor for advice.

To find out more about your medicine, you can:

• check the leaflet that comes with it
• search for your medicine leaflet on the electronic medicines compendium website
• speak to a pharmacist or doctor for advice – if you recently started taking it, you can get help with newly prescribed medicines from a pharmacist as part of the New Medicine Service