How does this medication work? What will it do for me?

Digoxin is used to treat congestive heart failure and to treat certain types of abnormal heart rhythms. It helps to reduce the symptoms of congestive heart failure (e.g., swelling in the ankles, feet, and hands; shortness of breath; frequent fatigue) by helping to increase the strength of the heart so that it pumps more efficiently. Digoxin also helps to maintain a normal heart rhythm in patients with atrial fibrillation.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

0.0625 mg
Each round, peach, flat-faced, bevelled edge tablet, debossed "TOLOXIN" over a score line and "06" under it on one side and plain on the other side, contains digoxin 0.0625 mg (62.5 µg). Nonmedicinal ingredients: FD&C Yellow No. 6, lactose, magnesium stearate, and starch (corn).

0.125 mg
Each round, yellow, flat-faced, bevelled edge tablet, debossed "TOLOXIN" over a score line and "12" under it on one side and plain on the other side, contains digoxin 0.125 mg (125 µg). Nonmedicinal ingredients: D&C Yellow No. 10, lactose, magnesium stearate, starch (corn), and yellow ferric oxide.

0.25 mg
Each round, white, biconvex tablet, debossed "TOLOXIN" over a score line and "25" under it on one side and plain on the other side, contains digoxin 0.25 mg (250 µg). Nonmedicinal ingredients: lactose, magnesium stearate, and starch (corn).

How should I use this medication?

The dose varies widely depending on age, disease, weight, and kidney function. Higher doses are often given at the start of treatment, but daily adult doses usually range between 0.0625 mg and 0.25 mg. Children's doses are individually determined by their doctor.

Digoxin is normally taken once daily at the same time each day.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is very important to use this medication exactly as prescribed by your doctor. If you miss a dose, and you remember it within 12 hours, administer it as soon as possible and continue on with your regular schedule. If it is more than 12 hours after your last dose, skip the missed dose and continue on with your regular dosing schedule. Do not administer a double dose to make up for a missed one. If you miss 2 doses in a row, call your doctor for instruction.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Digoxin should not be used by anyone who:

  • is allergic to digoxin or to any of the ingredients of the medication
  • has certain abnormal heart rhythms (ventricular fibrillation)

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • anxiety, blurred or yellow vision, confusion, dizziness, depression, feeling of not caring, headache, loss of appetite, hallucinations, or weakness
  • diarrhea, loss of appetite, lower stomach pain, nausea, or vomiting
  • irregular or slow heartbeat, palpitations (feeling of pounding in the chest), or fainting

Infants and children: The signs and symptoms listed above can also occur for infants and children, but heartbeat rate or heart rhythm side effects are more common initially than stomach upset, loss of appetite, changes in vision, or other side effects.

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Kidney disease: People with kidney disease may need a lower dose of digoxin.

Magnesium levels: Low blood levels of magnesium increase the risk of side effects with digoxin. It is important that magnesium levels be checked periodically when taking digoxin.

Potassium levels: Low blood levels of potassium increase the risk of overdose with digoxin. It is important that potassium levels be checked periodically, especially when taking medications that can change the levels of potassium in the blood (e.g., hydrochlorothiazide, furosemide).

Potential overdose: The difference between an effective dose and an overdose is less for this medication than for most. Therefore, it is important to take digoxin exactly as prescribed. Anyone developing loss of appetite, nausea, or vomiting while taking this medication should contact their doctor, as it may be a sign that the dose is too high.

Pregnancy: Digoxin should be taken by pregnant women only if clearly needed, as the effects of this medication during pregnancy are currently unknown.

Breast-feeding: The amount of digoxin that passes into breast milk is not likely to affect a breast-fed infant. Nevertheless, caution should be used when digoxin is taken by a breast-feeding woman.

Children: This medication can be prescribed to children. Keep this medication out of the reach of children.

Seniors: As you age, your kidney function can get poorer. If this happens you may need a lower dose of this medication. Do not change the dose on your own - check with your doctor to find out what is the best dose for you.

What other drugs could interact with this medication?

There may be an interaction between digoxin and any of the following:

  • acarbose
  • amiodarone
  • amphetamines
  • antacids
  • beta-blockers (e.g., propranolol)
  • calcium
  • calcium channel blockers (e.g., diltiazem, nifedipine, verapamil)
  • certain anticancer medications (e.g., bleomycin, carmustine)
  • colestipole
  • cholestyramine
  • clarithyromycin
  • cyclosporine
  • diphenoxylate
  • diuretics that reduce levels of potassium (e.g., hydrochlorothiazide, furosemide)
  • erythromycin
  • indomethacin
  • itraconazole
  • kaolin - pectin
  • levothyroxine
  • medications for overactive thyroid (e.g., methimazole, propylthiouracil)
  • metoclopramide
  • neomycin
  • penicillamine
  • phenytoin
  • propafenone
  • propantheline
  • quinidine
  • quinine
  • spironolactone
  • St. John's wort
  • sulfasalazine
  • tetracyclines (e.g., doxycycline, minocycline, tetracycline)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.