Congestive Heart Failure in Adults
Atrial Fibrillation in Adults
How it works
Digoxin is derived from the leaves of a digitalis plant. Digoxin helps make the heart beat stronger and with a more regular rhythm.
It increases the force and velocity of myocardial systolic contraction (positive inotropic action), a slowing of the heart rate (negative chronotropic effect), decreased conduction velocity through the AV node, and a decrease in the degree of activation of the sympathetic nervous system and renin-angiotensin system (neurohormonal deactivating effect).
Indications
Congestive Heart Failure in Adults
Atrial Fibrillation in Adults
Dosage
Heart failure
Adult: Rapid digitalisation: Loading dose of 0.50-1.5 mg during the first 24-hr period as a single dose or in divided doses every 6 hr for less urgent or greater risk cases. For mild heart failure: Loading dose may not be required, 250 mcg 1-2 times daily. For patients with normal renal function, steady-state plasma concentrations are usually achieved in about 7 days.
Usual maintenance: 125-250 mcg daily but may range from 62.5-500 mcg daily.
Elderly: Lower doses are given.
Supraventricular arrhythmias
Adult: Rapid digitalisation: Loading dose of 0.75-1.5 mg during the first 24-hr period as a single dose or in divided doses every 6 hr for less urgent or greater risk cases. For mild heart failure: Loading dose may not be required, 250 mcg 1-2 times daily. For patients with normal renal function, steady-state plasma concentrations are usually achieved in about 7 days.
Usual maintenance: 125-250 mcg daily but may range from 62.5-500 mcg daily.
Elderly: Lower doses are given.
Side Effects
Extra beats, anorexia, nausea and vomiting. Diarrhoea in elderly, confusion, dizziness, drowsiness, restlessness, nervousness, agitation and amnesia, visual disturbances, gynaecomastia, local irritation (IM/SC inj), rapid IV admin may lead to vasocostriction and transient hypertension. Potentially Fatal: Cardiac arrhythmias in combination with heart block
Contraindication
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