{"ok":true,"entry":{"slug":"digoxin","kind":"medication","name":"digoxin","aliases":["Lanoxin"],"brands_sg":["Lanoxin","Lanoxin-PG","Digokern"],"class":"cardiac glycoside","tags":["heart-bp"],"use_for":"prescribed for atrial fibrillation and heart failure","use_after":"healthhub: with or after food","use_duration":null,"take_with":"food · healthhub: with or after food","pros":["healthhub: slows down a rapid heart rate","healthhub: strengthens the force of the heartbeat","fda: improves hf symptoms and exercise capacity"],"cons":["fda: toxic levels are only slightly above therapeutic","healthhub: blurred or yellow vision may mean too high","fda: can worsen or cause abnormal heart rhythms"],"dose_note":"the us lanoxin tablet label sets no single maximum: adult maintenance 'is based on lean body weight, renal function, age, and concomitant products', its recommended starting-dose table for adults runs up to 500 micrograms once daily (100 kg lean weight, creatinine clearance 100 ml/min), and oral loading for adults over 10 years is 10–15 mcg/kg. the same label notes toxicity 'is usually associated with digoxin levels greater than 2 ng/mL'. sg registers 0.25 mg and 0.0625 mg tablets, an elixir and an injection. in singapore the prescriber sets the dose.","dosage":null,"ul_status":null,"sg_class":"prescription-only","cautions":["kidney disease — healthhub; fda: dose depends on renal function","low body weight or advanced age — fda: predispose to toxicity","low potassium or magnesium, or high calcium — fda: predispose to toxicity","wolff-parkinson-white, sinus node disease or av block — fda: risk of arrhythmia"],"clashes":[{"src":["fda_dig_di"],"note":"fda: digoxin levels rise more than 50%; levels are measured first and the dose cut by about 30–50%","with":"amiodarone, dronedarone, quinidine, verapamil, propafenone"},{"src":["fda_dig_di"],"note":"fda: digoxin levels rise more than 50%; monitoring and dose reduction are needed","with":"clarithromycin, erythromycin, itraconazole, ritonavir"},{"src":["fda_dig_di"],"note":"fda: digoxin levels rise by less than 50%; dose cut by about 15–30% with monitoring","with":"mirabegron, spironolactone, diltiazem, quinine, ticagrelor"},{"src":["fda_dig_pd"],"note":"fda: a fall in gfr or tubular secretion may impair the excretion of digoxin","with":"ace inhibitors, arbs, nsaids and cox-2 inhibitors"},{"src":["fda_dig_pd"],"note":"fda: higher rate of torsades de pointes with dofetilide; more proarrhythmic events with sotalol","with":"dofetilide or sotalol"}],"sources":[{"id":"hsa_register","url":"https://data.gov.sg/datasets/d_767279312753558cbf19d48344577084/view","label":"HSA — Listing of Registered Therapeutic Products (data.gov.sg open dataset, 5,511 rows; cached at /tmp/hsa_all.json and filtered locally, not re-fetched)","quote":"All 5 registered digoxin products read Forensicclassification 'Prescription Only' — SIN01198P LANOXIN TABLET 0.25 mg · SIN01203P LANOXIN-PG 0.0625 mg · SIN00544P LANOXIN ELIXIR 0.05 mg/ml · SIN00547P LANOXIN INJECTION · SIN17078P DIGOKERN TABLETS 0.25MG (C01AA05)","accessed":"2026-08-27"},{"id":"hh_dig_uses","url":"https://www.healthhub.sg/medication-devices-and-treatment/medications/digoxin","label":"HealthHub (Pharmaceutical Society of Singapore) — Digoxin: what is this medication for","quote":"Digoxin is used primarily to slow down rapid heart rate. It is also used in heart failure to improve heart function by strengthening the force of your heartbeat.","accessed":"2026-08-27"},{"id":"hh_dig_admin","url":"https://www.healthhub.sg/medication-devices-and-treatment/medications/digoxin","label":"HealthHub — Digoxin: how should I take or use this medication","quote":"Do not stop taking your medication without checking with your healthcare professional. You should take this medication with or after food.","accessed":"2026-08-27"},{"id":"hh_dig_precautions","url":"https://www.healthhub.sg/medication-devices-and-treatment/medications/digoxin","label":"HealthHub — Digoxin: what precautions should I take","quote":"You have kidney disease. You are taking any other medications, including supplements, traditional medications and herbal remedies.","accessed":"2026-08-27"},{"id":"hh_dig_se","url":"https://www.healthhub.sg/medication-devices-and-treatment/medications/digoxin","label":"HealthHub — Digoxin: common side effects","quote":"Problems with your vision – sudden change (blurring) in eyesight, yellow vision … These may indicate that the dose of digoxin may be too high for you.","accessed":"2026-08-27"},{"id":"fda_dig_ind","url":"https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22LANOXIN%22+AND+openfda.route:%22ORAL%22&limit=3","label":"US FDA label for LANOXIN (digoxin) tablets, Indications and Usage, via openFDA (effective 2024-12-05)","quote":"LANOXIN increases left ventricular ejection fraction and improves heart failure symptoms, as evidenced by improved exercise capacity … indicated for the control of ventricular response rate in adult patients with chronic atrial fibrillation","accessed":"2026-08-27"},{"id":"fda_dig_dose","url":"https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22LANOXIN%22+AND+openfda.route:%22ORAL%22&limit=3","label":"US FDA label for LANOXIN tablets, sections 2.1–2.3 Dosage and Administration, via openFDA","quote":"toxic levels of digoxin are only slightly higher than therapeutic levels … The maintenance dose is based on lean body weight, renal function, age … Recommended LANOXIN Oral Loading Dose … over 10 years 10-15 mcg/kg","accessed":"2026-08-27"},{"id":"fda_dig_table","url":"https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22LANOXIN%22+AND+openfda.route:%22ORAL%22&limit=3","label":"US FDA label for LANOXIN tablets, section 2.3 Table 3 (recommended maintenance dose by lean body weight and renal function), via openFDA","quote":"Recommended Maintenance Dose (in micrograms given once daily) of LANOXIN … by Lean Body Weight and by Renal Function … 100 mL/min 187.5 250 312.5 312.5 375 437.5 500","accessed":"2026-08-27"},{"id":"fda_dig_warn","url":"https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22LANOXIN%22+AND+openfda.route:%22ORAL%22&limit=3","label":"US FDA label for LANOXIN tablets, sections 4–5 Contraindications, Warnings and Precautions, via openFDA","quote":"Toxicity is usually associated with digoxin levels greater than 2 ng/mL … Low body weight, advanced age or impaired renal function, hypokalemia, hypercalcemia, or hypomagnesemia may predispose to digoxin toxicity","accessed":"2026-08-27"},{"id":"fda_dig_di","url":"https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22LANOXIN%22+AND+openfda.route:%22ORAL%22&limit=3","label":"US FDA label for LANOXIN tablets, section 7.2 Pharmacokinetic Drug Interactions, via openFDA","quote":"Digoxin concentrations increased greater than 50%: Amiodarone … Clarithromycin … Dronedarone … Erythromycin … Itraconazole … Propafenone … Quinidine … Ritonavir … Verapamil … Reduce digoxin … by decreasing dose by approximately 30-50%","accessed":"2026-08-27"},{"id":"fda_dig_pd","url":"https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22LANOXIN%22+AND+openfda.route:%22ORAL%22&limit=3","label":"US FDA label for LANOXIN tablets, section 7.3 Potentially Significant Pharmacodynamic Drug Interactions, via openFDA","quote":"A decline in GFR or tubular secretion, as from ACE inhibitors, angiotensin receptor blockers, nonsteroidal anti-inflammatory drugs [NSAIDS], COX-2 inhibitors may impair the excretion of digoxin … Dofetilide … a higher rate of torsades de pointes","accessed":"2026-08-27"}],"brand_certs":null,"updated_at":"2026-08-29T16:16:18.585742+08:00"},"disclaimer":"kozen-x is not a medical device and does not give medical advice. it lists what published sources have written down. absence of a record is not the same as safe."}