Lanoxin

1 What is Lanoxin?

Brand: Lanoxin, Lanoxin Pediatric

Generic: Digoxin

Lanoxin is used to treat congestive heart failure, normally combined with a diuretic and an angiotensin-converting enzyme (ACE) inhibitor. It is also used to treat a heart rhythm problem called atrial fibrillation.

Lanoxin belongs to a class of medications called digitalis glycosides. It is used to improve the strength and efficiency of the heart or to control the rate and rhythm of the heartbeat.

This leads to better blood circulation and reduced swelling of the hands and ankles in patients with heart problems.

This medication is only available with your doctor’s prescription. This product is available in the following dosage forms:

  • Solution
  • Injectable

2 What to Know Before Using

Before using Lanoxin, you must know all about the risks and complications associated with it. This is a decision that you and your doctor will make together.

For this medication, there are many things that need to be considered:

Allergies: Inform your doctor if you have ever had an allergic reaction to any other medications. It is also important to inform your doctor of any non-medicine allergies such as foods, dyes, preservatives or animals.

Pediatric: Up-to-date Pediatric Appropriate studies have not indicated any problems that would limit the use of this medication in children with heart failure. Individual dosing may be required for infants, who are very sensitive to the effects of this medication.

No appropriate studies have been performed on the relationship of age to the effects of this medication in children with atrial fibrillation. Safety and efficacy have not been established.

Geriatric: Up-to-date studies have not shown any problems specific to the elderly that would limit the use of this medication in the elderly population. However, elderly patients are more likely to have age-related kidney or heart problems, which may require caution.

Pregnancy: This medication is listed as Pregnancy Category C. This means that animal studies have shown an adverse effect and no studies have been performed on pregnant women OR there are no adequate studies on pregnant animals and pregnant women.

Breastfeeding: Studies in women suggest that this medication poses minimal risk to the infant when used while breastfeeding. Using this medication with any of the following is not recommended.

Your doctor may decide not to treat you with this medication, or change some of the other medications you take:

  • Amifampridine

Using this medication with any of the following medication is not recommended, but may be unavoidable in some cases. 

Your doctor may make the decision not to treat you with this medication or change some of the other medications you take:

  • Alprazolam
  • Amiodarone
  • Bemetizide
  • Bendroflumethiazide
  • Benzthiazide
  • Boceprevir
  • Buthiazide
  • Calcium
  • Canagliflozin
  • Chan Su
  • Chlorothiazide
  • Chlorthalidone
  • Clarithromycin
  • Clopamide
  • Cobicistat
  • Conivaptan
  • Crizotinib
  • Cyclopenthiazide
  • Cyclothiazide
  • Daclatasvir
  • Demeclocycline
  • Difenoxin
  • Diphenoxylate
  • Dofetilide
  • Dopamine
  • Doxycycline
  • Dronedarone
  • Eliglustat
  • Epinephrine
  • Erythromycin
  • Fingolimod
  • Hydrochlorothiazide
  • Hydroflumethiazide
  • Ibuprofen
  • Indapamide
  • Indomethacin
  • Isavuconazonium Sulfate
  • Itraconazole
  • Kyushin
  • Lapatinib
  • Ledipasvir
  • Lily of the Valley
  • Lomitapide
  • Methyclothiazide
  • Metolazone
  • Mifepristone
  • Minocycline
  • Moricizine
  • Nilotinib
  • Norepinephrine
  • Oleander
  • Oxytetracycline
  • Pheasant's Eye
  • Polythiazide
  • Propafenone
  • Propantheline
  • Quercetin
  • Quinethazone
  • Quinidine
  • Ritonavir
  • Rolapitant
  • Saquinavir
  • Simeprevir
  • Spironolactone
  • Squill
  • Succinylcholine
  • Telaprevir
  • Tetracycline
  • Tocophersolan
  • Trichlormethiazide
  • Ulipristal
  • Vandetanib
  • Vemurafenib
  • Verapamil
  • Vilazodone
  • Xipamide

Using this medication with any of the following medications may increase your risk of side effects. However, using both medications may be the best treatment for you.

If both medications are prescribed together, your doctor may change the dose or how often you take one or both medications:

  • Acarbose
  • Acebutolol
  • Alprenolol
  • Arbutamine
  • Atenolol
  • Atorvastatin
  • Azithromycin
  • Azosemide
  • Bepridil
  • Betaxolol
  • Bevantolol
  • Bisoprolol
  • Bucindolol
  • Canrenoate
  • Captopril
  • Carteolol
  • Carvedilol
  • Cascara Sagrada
  • Celiprolol
  • Colchicine
  • Cyclosporine
  • Darunavir
  • Dilevalol
  • Diltiazem
  • Disopyramide
  • Epoprostenol
  • Esmolol
  • Etravirine
  • Exenatide
  • Flecainide
  • Fluoxetine
  • Furosemide
  • Gatifloxacin
  • Hydroxychloroquine
  • Indecainide
  • Labetalol
  • Lenalidomide
  • Lornoxicam
  • Mepindolol
  • Metipranolol
  • Metoclopramide
  • Metoprolol
  • Mibefradil
  • Miglitol
  • Mirabegron
  • Nadolol
  • Nebivolol
  • Nefazodone
  • Nilvadipine
  • Nisoldipine
  • Nitrendipine
  • Omeprazole
  • Oxprenolol
  • Pancuronium
  • Paromomycin
  • Penbutolol
  • Pindolol
  • Piretanide
  • Posaconazole
  • Propranolol
  • Quinine
  • Rabeprazole
  • Ranolazine
  • Rifampin
  • Rifapentine
  • Roxithromycin
  • Simvastatin
  • Sotalol
  • Sulfasalazine
  • Talinolol
  • Telithromycin
  • Telmisartan
  • Tertatolol
  • Ticagrelor
  • Timolol
  • Torsemide
  • Tramadol
  • Trazodone
  • Trimethoprim

Other Interactions: Certain medications should not be used while eating, or while eating certain foods in the case of negative interactions. Using alcohol or tobacco with certain medications may also cause negative interactions. Talk with your doctor about the use of your medication with food, alcohol or tobacco.

Other Medical Problems: Pre-existing medical problems may affect the use of this medication.

Be sure to tell your doctor if you have any other medical problems, especially:

  • AV block (type of abnormal heart rhythm), with no pacemaker
  • Heart disease (i.e. amyloid heart disease, constrictive pericarditis, cor pulmonale, hypertrophic or restrictive cardiomyopathy)
  • Hypercalcemia (high calcium in the blood)
  • Hypokalemia (low potassium in the blood)
  • Hypomagnesemia (low magnesium in the blood)
  • Sick sinus syndrome (type of abnormal heart rhythm), with no pacemaker
  • Wolff-Parkinson-white syndrome (heart rhythm problem) - Use with caution. May make these conditions worse.
  • Blood vessel disease (i.e. arteriovenous shunt)
  • Diarrhea
  • Hypocalcemia (low calcium in the blood)
  • Hypoxia (low oxygen in the blood)
  • Thyroid disease - Use with caution. Patients with these conditions may be less sensitive or resistant to the effects of digoxin injection.
  • Electrical cardioversion (a medical procedure) - Dose of digoxin injection may be reduced 1 to 2 days prior to electrical cardioversion of atrial fibrillation to avoid worsening of the condition.
  • Heart attack - Use of digoxin is not recommended in patients with this condition.
  • Kidney disease - Use with caution. The effects may be increased because of slower removal from the body.
  • Ventricular fibrillation (heart rhythm problem) - Should not be used in patients with this condition.

3 Proper Usage

Proper usage of Lanoxin requires strict adherence to your doctor’s orders. A nurse or other trained health professional will give you this medication. This medication is given through a needle placed in one of your veins (intravenously).

Your doctor will give you a few doses of this medication until your condition improves and then will switch you to an oral medication that works the same way. Talk to your doctor about any concerns or questions you may have.

4 Precautions to Take

Before using Lanoxin, there are some precautions you must take. It is very important that your doctor checks in with you often while you are receiving this medication to make sure that it is working properly.

Do not take other prescription or over-the-counter medications without asking your doctor.Your doctor may want you to carry a medical ID card or bracelet stating that you are taking this medication

Be mindful of signs and symptoms of overdose while taking this medication. The amount of medication needed to help most people is very close to the amount that could cause serious problems for an overdose.

Early warning signs of an overdose include confusion, loss of appetite, nausea, vomiting, diarrhea or vision problems. Other signs include changes in heartbeat, palpitations, or fainting (syncope).

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Lanoxin. Although not all of these side-effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if you experience any of the following side-effects:

More common:

Rare:

  • Black, tarry stools
  • Bleeding gums
  • Blood in the urine or stools
  • Bloody vomit
  • Pinpoint red spots on the skin
  • Rash with flat lesions or small raised lesions on the skin
  • Severe stomach pain
  • Unusual bleeding or bruising

Get emergency help if any of the following symptoms of overdose occur:

  • Abdominal or stomach pain
  • Confusion
  • Drowsiness
  • General feeling of discomfort or illness (malaise)
  • Green-yellow color disturbances
  • Halos around lights
  • Loss of appetite
  • Nervousness
  • Numbness or tingling in the hands, feet, or lips
  • Vomiting
  • Weakness or heaviness of the legs
  • Weight loss

Some side effects that may occur do not normally need medical attention. These may leave as your body becomes accustomed to treatment. Ask your doctor about ways to prevent or reduce some of these side effects.

Talk to your doctor if any of the following side effects continue or are bothersome, or if you have questions:

Less common:

Some patients may experience other side effects that are not listed. Check with your doctor if you notice any other side effects. Ask your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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