Digoxin

Digoxin is a medicine used when the heart does not pump properly. It is also used to treat some abnormal heart rhythms. This information sheet describes how this medicine is given and some of its possible side effects.

Digoxin has a direct action on the heart to increase the pumping action, and to control some fast heart rhythms.

It is usually given once or twice a day. It is available as 50 micrograms in 1ml oral liquid. An oral syringe is provided to measure small doses. For older children, tablets are available in the following strengths: 62.5 micrograms, 125 micrograms and 250 micrograms.

Side effects are rare but occasionally cause:

• Either slow or fast heart rate
• Feeling sick, vomiting, diarrhorea.
• Confusion, anxiety, mental disturbances or disorientation
• Visual disturbances including blurred or double vision, halo or green/yellow tinge to vision.

It can also cause skin rash, dizziness and headache. If you are concerned about any of these side effects, please discuss them with your doctor.

People with the following conditions should discuss taking digoxin with their doctor:

• pregnant, could be pregnant, planning to become pregnant or breastfeeding
• kidney disease
• overactive or underactive thyroid function

Some medicines can interact with digoxin. Always check with your prescriber or pharmacist before giving your child any other medicines, including herbal or complementary medicines. The following are known to react with digoxin:

• Amiodarone, beta-blockers, verapamil, diltiazem and other anti-arrhythmic drugs: Sometimes these are prescribed alongside digoxin. They also slow the heart rate and can have an additional effect.
• Furosemide, amiloride, spironolactone, ACE inhibitors, and potassium supplements: These are commonly prescribed alongside digoxin. They alter the level of potassium in the body and can affect how the heart responds to digoxin. A blood test can show if the potassium level is in the right range
• Antibiotics called macrolides such as erythromycin and clarithromycin can increase the level of digoxin in the body
• Non steroidal anti-inflammatory drugs such as diclofenac and ibuprofen may increase the level of digoxin in the body
• St John’s Wort: may decrease the effectiveness of digoxin

• Keep medicines in a safe place where children cannot reach them.
• Keep medicines in a cool, dry place out of direct sunlight and away from heat.
• If your doctor decides to stop treatment with digoxin, return any unused medicine to the pharmacist. Do not flush down the toilet or throw it away.
• If you forget to give your child a dose, give it as soon as you remember. Do not give a double dose.
• If you child vomits after taking the medicine, do not give a double dose.
• Your family doctor (GP) will need to give you a repeat prescription for digoxin. Some medicines will need to be ordered by your community pharmacy (chemist) so arrange this in plenty of time.