- Heart failure
- Atrial fibrillation with an uncontrolled ventricular rate
- Acute left ventricular failure
- Chronic left ventricular failure and congestive heart failure, especially when caused by hypertensive valvular (especially mitral valvular) disease or ischaemic heart disease.
Dosage & Administration
For less urgent digitalisation: 0.25 to 0.5 mg daily(higher dose may be divided); Maintenance: 0.0625 to 0.5 mg daily (higher dose may be divided) accordingly to renal function and in atrial fibrilation on heart rate response;
Usual dose: 0.125 to 0.25 mg daily (lower dose my be appropriate in elderly).
Potentially Fatal: Electrolyte imbalances such as hypokalaemia and hypomagnesemia (e.g. admin of potassium-losing diuretics, corticosteroids) can increase the risk of cardiac toxicity.
Pregnancy & Lactation
Use in lactation: Digoxin is excreted in breast milk but in concentration below those found in plasma and therefore poses no hazard to the breast-feed infant.
Management: Treatment is symptomatic and supportive. Reduce absorption by gastric lavage if present within 30 min of ingestion. Do not induce vomiting or attempt passage of a gastric tube if presented >2 hr after ingestion or already has toxic manifestations, as this may induce an acute vagal episode and worsen digitalis-related arrhythmias. Activated charcoal is helpful in reducing drug absorption.
Use in Special Population
Use in elderly: Partly because of reduced renal function and partly because of their tissues are more sensitive to the effects of digitalis, the elderly require lower maintenance dose of digoxin than younger adults