Rinfocan- Prescription Drug Information for Canadians
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DIGITALIS GLYCOSIDES
(Type of Drug)
BRAND NAMES
GENERIC NAME: DIGITOXIN
Digitaline
GENERIC NAME: DIGOXIN
Lanoxin, 0.125 mg
Lanoxin, 0.25 mg
PRESCRIBED FOR
Congestive heart failure and other heart abnormalities.
GENERAL INFORMATION
Digitalis glycosides directly affect the myocardium (heart
muscle), depending on the dose you are taking. They improve
your heart's pumping ability or helps to control its beating
rhythm. Patients with heart problems very often notice swelling
of the feet, ankles, and hands. Digitalis drugs improve this
symptom by improving drug circulation.
Digitoxin is more useful than Digoxin in patients who have
kidney problems. Digitoxin is not removed from the body by the
kidneys, but mostly by the liver.
These medications are generally used for long periods of time.
CAUTIONS AND WARNINGS
Do not use these drugs if you know you are allergic or sensitive
to digitalis. Long-term use of a digitalis drug can cause the body
to lose potassium, especially since digitalis drugs are generally
used in combination with diuretic drugs. For this reason, be sure
to eat a well-balanced diet and emphasize foods that are high in
potassium such as bananas, citrus fruits, melons, and tomatoes.
PREGNANCY/BREAST-FEEDING
Digitalis drugs cross into the blood circulation of a developing
baby. They have not been found to cause birth defects.
Nevertheless, pregnant women, or those who might become
pregnant while taking one of these drugs, should not take it
without their doctors' approval. When the drug is considered
essential by your doctor, the potential risk of taking the medicine
must be carefully weighed against the benefit it might produce.
Digitalis drugs pass into breast milk, but have caused no
problems among breast-fed infants. You must consider the
potential effect on the nursing infant if breast-feeding while
taking one of these medicines.
SENIORS
Older adults are more sensitive to the effects of digitalis drugs,
especially loss of appetite. Follow your doctor's directions and
report any side effects at once.
POSSIBLE SIDE EFFECTS
The most common side effects are loss of appetite, nausea,
vomiting, diarrhea, and blurred or disturbed vision. If you
experience any of these problems, discuss them with your doctor
immediately.
Enlargement of the breasts has been reported after longterm use
of a digitalis drug, but this is uncommon. Allergy or sensitivity to
digitalis drugs is also uncommon.
DRUG INTERACTIONS
Barbiturates, Phenytoin, antidiabetic drugs, Phenylbutazone, and
Rifampin will counteract the effectiveness of a digitalis drug by
stimulating its breakdown by your liver.
The absorption of a digitalis drug into your bloodstream is
reduced by taking it together with antacids, kaolin-pectin
mixtures, Cholestyramine, or Colestipol. Other drugs that can
prevent digitalis drugs from being absorbed are oral Kanamycin,
Metoclopramide, and oral Neomycin.
Drugs that may increase the effect of a digitalis drug are
anticholinergic drugs, Erythromycin and Tetracycline,
Hydroxychloroquine, Nifedipine, and Verapamil.
Low blood potassium, a common side effect of thiazide diuretics,
Furosemide, Ethacrynic Acid, and Bumetanide, will increase a
digitalis drug's effect and increase the chance of developing a
toxic side effect.
Spironolactone can either increase or decrease the effect of a
digitalis drug. The effect is unpredictable.
Quinidine may increase the amount of a digitalis drug in your
blood by 2 to 3 times, beginning 1 to 3 days after the Quinidine
is started.
The effects of a digitalis drug on your heart may be additive to
those of the Ephedrine, Epinephrine, and other stimulants; beta
blockers; calcium salts; Procainamide; and Rauwolfia drugs.
Thyroid drugs will change your digitalis drug requirement. Your
doctor will have to make a dosage adjustment if you start taking
a thyroid drug.
FOOD INTERACTIONS
Take each day's dose after your morning meal.
USUAL DOSE
DIGITOXIN
Adult: The first dose--known as the digitalizing dose--is 2
milligrams over about 3 days, or 0.4 milligram per day for 4 days.
Maintenance dose ranges from 0.05 to 0.03 milligram daily.
Senior: lower doses, because seniors are more sensitive to
adverse effects.
Infant and child: The first dose depends on age but can be from
0.01 milligram per pound to 0.02 milligram per pound.
Maintenance dose is one-tenth the first dose.
DIGOXIN
Adult: The first dose--known as the digitalizing dose--is 1 to 1.5
milligrams. Maintenance dose ranges from 0.125 to 0.5
milligram.
Senior: lower doses, because seniors are more sensitive to
adverse effects.
Infant and child: substantially lower dose.
OVERDOSAGE
Symptoms are loss of appetite, nausea, vomiting, diarrhea,
headache, weakness, apathy, blurred vision, yellow or green
spots before the eyes, yellowing of the skin and eyes, or
changes in heartbeat. Contact your doctor immediately if any of
these symptoms appear. An early sign of overdose in children is
change in heart rhythm. Vomiting, diarrhea, and eye trouble are
frequently seen in older people.
SPECIAL INFORMATION
Do not stop taking this medicine unless your doctor tells you to.
Avoid nonprescription medicine containing stimulants. Your
pharmacist can tell you which nonprescription medicine is safe
for you.
Call your doctor if you develop loss of appetite, stomach pains,
nausea or vomiting, diarrhea, unusual tiredness or weakness,
visual disturbances, or mental depression.
There are considerable variations among digitalis drug tablets
made by different manufacturers. Do not change brands without
telling your doctor.
If you forget to take a dose of a digitalis drug, do not take the
forgotten dose. Skip the dose and go back to your regular
schedule. Do not take a double dose. Call your doctor if you
forget to take your medicine for 2 or more days.
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