Lanoxin (Digoxin) Oral: Uses, Side Effects, Dosages - Verywell Health
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What Is Lanoxin?
Lanoxin (digoxin) is an oral prescription medication used to treat irregular heartbeats associated with mild to moderate heart failure.
Digoxin originates naturally from the foxglove plant, which contains an ingredient called Digitalis lanata. Digitalis helps the heart muscle work properly in someone with a rapid or abnormal heartbeat.
Digoxin is available orally in tablet and liquid solution forms. It can also be given as an injection into the vein (intravenously) or the muscle (intramuscularly). This medication may be toxic if not calculated correctly when dosing in specific patients.
Drug Facts
Generic Name: Digoxin
Brand Name(s): Lanoxin
Drug Availability: Prescription
Therapeutic Classification: Cardiovascular agent
Available Generically: Yes
Controlled Substance: N/A
Administration Route: Oral
Active Ingredient: Digoxin
Dosage Form(s): Tablet, solution
What Is Lanoxin Used For?
The Food and Drug Administration (FDA) approved Lanoxin to treat adults with mild to moderate heart failure or heart issues involving an irregular heartbeat. This medication should be used in combination with other heart medications for optimal results in those hospitalized with heart failure.
Heart failure can occur in people of all ages, including children. Lanoxin is also approved for use in children with heart failure to improve their heart function.
How to Take Lanoxin
Lanoxin should be carefully taken as an oral medication and dosed by a healthcare provider. Avoid foods high in fiber when taking digoxin, as it may reduce the amount of the drug absorbed in the body.
However, you can take this medication with other foods, as it may slow the absorption of the medicine but will not reduce your dose as ingesting foods high in fiber would.
Lanoxin is often given through the veins as an injection to hospitalized patients for a rapid response, which is the preferred route of administration compared to an injection into the muscle.
Storage
Lanoxin should be stored at 77 F or room temperature (between 68 F and 77 F). If traveling, it is safe to expose to temperatures up to 86 F or as low as 59 F.
Once you are ready to store your medication for safekeeping, store it in a dry and dark area protected from light. Keep it high up in a childproof, light-resistant, and tightly closed container, away from children or pets.
Off-Label Uses
Lanoxin is sometimes used off-label for fetal heart issues. Although not approved by the FDA for this use, Lanoxin has been researched by the American Heart Association for its role in treating fetal supraventricular tachyarrhythmia (SVT), the most common form of fetal tachycardia (rapid heart rate).
Due to the advances in heart medicine and imaging technology, scientists and healthcare providers have been able to use medications such as Lanoxin to treat SVT in fetuses. This is a unique procedure, and many factors play a role in the safety and effectiveness of this potentially fatal administration.
How Long Does Lanoxin Take to Work?
An oral dose of Lanoxin may take two to three hours to take effect or even one hour depending on the dose and size of the person. If you feel more comfortable taking your medications with food, then the absorption of Lanoxin may take longer, and the medication may not peak until six hours later.
What Are the Side Effects of Lanoxin?
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.
Common Side Effects
Although common, if you experience any of these side effects and they don't go away or become intolerable, contact your healthcare provider immediately:
- Headaches
- Sleepiness
- Weakness
- Nausea or vomiting
- Stomach issues
- Lack of appetite
- Lack of concern or disturbed state of mind
- Hallucinations
- Anxiety or depression
Severe Side Effects
Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you're having a medical emergency.
The most concerning side effect of Lanoxin is blood toxicity due to taking too much medication. A toxic dose could cause severe disturbances in the heart, such as:
- An irregular heartbeat
- Fast heartbeat
- Fluttering of the heart or an inconsistent rhythm
Other side effects associated with digoxin toxicity include:
- Nausea and vomiting
- Persistent diarrhea
- Weakness
- Confusion
- Loss of appetite or weight
- Visual issues (yellow or blurred vision with possible spots in your vision)
Long-Term Side Effects
A possible issue with prolonged use of Lanoxin is the enlargement of male breasts, a condition known as gynecomastia.
Report Side Effects
Lanoxin may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088)
Dosage: How Much Lanoxin Should I Take?
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For heart failure or atrial fibrillation:
- For oral dosage form (solution):
- Adults, teenagers, and children 10 years of age and older—Dose is based on age, body weight, and medical condition and must be determined by your doctor. At first, the dose is usually 10 to 15 micrograms (mcg) per kilogram (kg) of body weight. Your doctor may adjust your dose as needed. However, the maintenance dose is usually 3 to 4.5 mcg per kg of body weight per day.
- Children 5 to 10 years of age—Dose is based on age, body weight, and medical condition and must be determined by your doctor. At first, the dose is usually 20 to 35 micrograms (mcg) per kilogram (kg) of body weight. Your doctor may adjust your dose as needed. However, the maintenance dose is usually 5.6 to 11.3 mcg per kg of body weight per day.
- Children 2 to 5 years of age—Dose is based on age, body weight, and medical condition and must be determined by your doctor. At first, the dose is usually 30 to 45 micrograms (mcg) per kilogram (kg) of body weight. Your doctor may adjust your dose as needed. However, the maintenance dose is usually 9.4 to 13.1 mcg per kg of body weight per day.
- Infants 1 month to 24 months of age—Dose is based on age, body weight, and medical condition and must be determined by your doctor. At first, the dose is usually 35 to 60 micrograms (mcg) per kilogram (kg) of body weight. Your doctor may adjust your dose as needed. However, the maintenance dose is usually 11.3 to 18.8 mcg per kg of body weight per day.
- Full-term babies—Dose is based on age, body weight, and medical condition and must be determined by your doctor. At first, the dose is usually 25 to 35 micrograms (mcg) per kilogram (kg) of body weight. Your doctor may adjust your dose as needed. However, the maintenance dose is usually 7.5 to 11.3 mcg per kg of body weight per day.
- Premature babies—Dose is based on age, body weight, and medical condition and must be determined by your doctor. At first, the dose is usually 20 to 30 micrograms (mcg) per kilogram (kg) of body weight. Your doctor may adjust your dose as needed. However, the maintenance dose is usually 4.7 to 7.8 mcg per kg of body weight per day.
- For oral dosage form (tablets):
- Adults—Your doctor will give your first few doses intravenously (rapid digitalization) and then, you'll be switched to oral tablets for maintenance therapy. A maintenance dose of 0.125 to 0.5 milligram (mg) once a day will be given depending on your body weight and medical condition.
- Teenagers and children older than 10 years of age—Dose is based on body weight and must be determined by your doctor.
- Children younger than 10 years of age—Use and dose must be determined by your doctor.
- For oral dosage form (solution):
Modifications
Special modifications may be needed for older 65 years and older, as this age population tends to have lesser kidney function compared with younger adults. Lower doses may be prescribed with consideration of weight, kidney function, and age.
Missed Dose of Lanoxin
Do not take more Lanoxin than prescribed or stop taking your medication altogether if you feel as though your symptoms aren't improving. If you miss a dose, do not take double the dose to catch up to your original regimen.
Taking two doses at the same time when not instructed by your healthcare provider could cause more harm than good. To prevent toxic side effects, take your medication as soon as you remember or take it at the same time the following day.
Overdose: What Happens If I Take Too Much Lanoxin?
Overdosing on Lanoxin can cause similar side effects as those mentioned above, such as:
- Nausea
- Vomiting
- Extreme weight loss
- Loss in energy
If you take too much Lanoxin, your healthcare provider may test the levels of the drug in your body. If the levels are too high, then an antidote may be given to help with reducing the high dose. Digibind (digoxin immune fab) is the antidote for all forms of digoxin overdose and is highly effective in reversing the effects of Lanoxin.
What Happens If I Overdose On Lanoxin?
If you think you or someone else may have overdosed on Lanoxin, call a healthcare provider or the Poison Control Center (800-222-1222).
If someone collapses or isn't breathing after taking Lanoxin, call 911 immediately.
Precautions
It is very important that your doctor check your progress closely while you are using this medicine to see if it is working properly and to allow for a change in the dose. Blood tests may be needed to check for any unwanted effects.
Do not stop taking this medicine without first checking with your doctor. Stopping suddenly may cause a serious change in heart function.
Watch for signs and symptoms of overdose while you are taking this medicine. Follow your doctor's directions carefully. The amount of this medicine needed to help most people is very close to the amount that could cause serious problems from overdose. Some early warning signs of overdose are confusion, loss of appetite, nausea, vomiting, diarrhea, or vision problems. Other signs of overdose are changes in the rate or rhythm of the heartbeat (becoming irregular or slow), palpitations (feeling of pounding in the chest), or fainting. In infants and small children, the earliest signs of overdose are changes in the rate and rhythm of the heartbeat. Children may not show the other symptoms as soon as adults.
Your doctor may want you to carry a medical identification card or bracelet stating that you are receiving this medicine.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
What Are Reasons I Shouldn't Take Lanoxin?
If you experience a severely rapid heartbeat to the point where you become dizzy or lose consciousness, then taking Lanoxin may not be the right medication for you. Get in touch with your healthcare provider or have someone call 911 immediately if you experience these symptoms.
It is also not recommended to take this medication if you are allergic to digoxin or are very sensitive to the use of this medication.
If you experience an unexplained rash or swelling of the lips, mouth, or throat and find it difficult to swallow or breathe, then stop what you are doing, discontinue taking Lanoxin, and call 911.
What Other Medications Interact With Lanoxin?
Digoxin can be affected by many types of medications.
Interactions can occur if you take digoxin with the following medications or drug classes:
- Antifungals that end with -azole (e.g., Sporanox (itraconazole))
- Macrolide antibiotics (e.g., Zithromax (azithromycin) or Biaxin XL (clarithromycin))
- Rifampin, an antibiotic
- Multaq (dronedarone), a class III antiarrhythmic drug
- Diuretics, or "water pills" (e.g., Lasix (furosemide))
- Quinidine, an antiarrhythmic and anti-parasitic drug
- Intravenous calcium products (e.g., calcium chloride)
This is a shortened list of potential drug interactions, and other medications not listed here may also interact with Lanoxin. Interactions can affect the absorption of Lanoxin, potentially causing too much exposure to the drug or reducing its efficacy. Your healthcare provider may need to monitor your treatment carefully if taking certain other medications with Lanoxin.
Ask your healthcare provider or pharmacist for a complete list of interactions that can occur with Lanoxin. Always tell your healthcare team what prescription or over-the-counter (OTC) drugs, vitamins, or herbal supplements you are currently taking.
What Medications Are Similar?
Digoxin is a unique and widely used add-on medication for heart failure. Other medications also used for heart failure include:
Although not in the same drug class as Lanoxin, the above medication can also be prescribed to treat heart failure and its complication. They may be used before beginning treatment with Lanoxin.
Other medications like Lanoxin that help regulate heart rate or rhythm include:
- Adenosine
- Betapace (sotalol)
- Rythmol SR (propafenone)
- Flecainide
- Tikosyn (dofetilide)
- Pacerone (amiodarone)
- Multaq (dronedarone)
This is a list of medications also used for similar uses as Lanoxin. It is not necessarily a list of treatments to take with Lanoxin; some of these drugs may interact with each other when taken simultaneously. Take your prescribed treatments as instructed by a healthcare provider or pharmacist.
How Can I Stay Healthy While Taking Lanoxin?
In addition to taking your medications as prescribed, you can adopt other heart-healthy methods to your lifestyle to improve your symptoms and overall quality of life.
For example, what you eat can be especially influential on the overall health of your heart. Try to minimize the amount of sodium and fat in the foods you eat and stick to an eating plan that includes a variety of fruits and vegetables, whole grains, healthy sources of protein (e.g., nuts and legumes, fish, and lean, unprocessed poultry), and nontopical vegetable oils.
Regular exercise also has many heart health benefits. Talk to your healthcare provider to come up with the right exercise plan for you.
Medical Disclaimer
Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
The author would like to recognize and thank Jaycob Peña for contributing to this article.
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