DR. MJ Bazos MD, Patient Handout
Digoxin

Why is digoxin prescribed?
Digoxin (say "dih-jock-sin") is a drug used to treat some heart problems. One of these problems, heart failure, results when the heart can't pump blood well enough to supply the body's needs. If you have heart failure, digoxin can improve your heart's ability to pump blood. Better pumping of the heart will often improve symptoms such as shortness of breath. Digoxin can also help a rapid or irregular heartbeat, such as atrial fibrillation (sometimes called "a-fib"). Digoxin helps by slowing down and controlling the heart rate. It may take several weeks to several months for digoxin to start working. Don't be surprised if you don't feel better right away. Keep taking your digoxin. Digoxin is used to treat heart conditions that last for a long time, so you may take digoxin the rest of your life. Call your doctor if you have any problems taking the drug.
How should I take my digoxin?
Digoxin is usually taken once a day. You should try to take the drug at the same time every day. It's very important to take your digoxin exactly as your doctor tells you. If you miss a dose, you may go ahead and take it if no more than 12 hours have passed from the time you should have taken it. If more than 12 hours have passed, skip that dose. Don't double up on digoxin doses. Don't suddenly stop taking your digoxin either, because this could make your heart problems worse. Some medicines and foods can decrease the amount of digoxin your body absorbs. These include the following:

• Liquid antacids (such as Maalox or Mylanta)
• Some cholesterol-lowering drugs (cholestyramine and colestipol)
• Some antidiarrheal medicines (such as Kaopectate)
• Bulk laxatives (such as psyllium, Metamucil or Citrucel)
• High-fiber foods (such as bran muffins) or nutritional supplements (such as Ensure)

Taking these medicines or eating high-fiber foods too close to the time you take your digoxin may result in too little digoxin in your bloodstream to help your heart. For this reason, it is better to take digoxin on an empty stomach. Check with your doctor before taking any of the medicines listed above. If your doctor says it's okay to take these medicines, keep two hours between a dose of digoxin and a dose of these medicines. Digoxin interacts with many other drugs. You should always tell your doctor and your pharmacist about all the medicines you are taking, including any over-the-counter drugs, natural remedies and herbal medicines. Always talk to your doctor or pharmacist before you take any new medicines.
How will my doctor know if I am getting enough digoxin?
The digoxin dose needed to treat heart conditions is different for different people. Your doctor may do a blood test to make sure you have the right amount of digoxin in your body. This blood test has to be done at least 6 hours after your last dose of digoxin. For this reason, you should tell your doctor when you normally take your digoxin. Ask your doctor if there is any special way to take your digoxin on the days your blood is drawn. Your doctor may want you to wait to take your dose. Or he or she may want to schedule your appointment so that you will have your blood drawn at the right time.
When should I call the doctor?
If you have heart failure, the following symptoms may mean that you are not getting enough digoxin. Call your doctor immediately if you have any of these symptoms:

• More shortness of breath than usual
• A decrease in your ability to climb stairs or walk
• Waking up short of breath at night
• Shortness of breath when you lie flat or sleep on several pillows
• More frequent trips to the bathroom during the night
• Increased ankle swelling or tightness of your shoes

If you have atrial fibrillation, the following symptoms may mean that you are not getting enough digoxin. If you develop any of these symptoms, call your doctor immediately:

• A rapid pulse (more than 100 beats per minute)
• Palpitations, or a feeling that your heart is racing
• A change in your heart rate
• Dizziness
• Fainting or blackouts

What are the side effects of digoxin?
You could have side effects, especially if you get too much digoxin. These side effects include nausea, vomiting, diarrhea, stomach pain, loss of appetite, unusual tiredness or weakness, slow heartbeat, palpitations, irregular heartbeat, drowsiness, confusion, fainting or changes in your vision (seeing a yellow, green or white halo around objects). It is important to pay attention to these side effects, because too much digoxin is dangerous.