Digoxin

Medication cardiac glycoside heart & blood pressure

Aka: Lanoxin

Brands seen in Singapore: Lanoxin, Lanoxin-PG, Digokern

Not medical advice. Check with your doctor or pharmacist before you start, stop or change the timing of anything you take.

How to use

What it’s for

Prescribed for atrial fibrillation and heart failure

When to take

HealthHub: with or after food

Take with

Food · HealthHub: with or after food

Pros & cons

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

Sources

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) · read 2026-08-27
what it says
“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)”
HealthHub (Pharmaceutical Society of Singapore) — Digoxin: what is this medication for · read 2026-08-27
what it says
“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.”
HealthHub — Digoxin: how should I take or use this medication · read 2026-08-27
what it says
“Do not stop taking your medication without checking with your healthcare professional. You should take this medication with or after food.”
HealthHub — Digoxin: what precautions should I take · read 2026-08-27
what it says
“You have kidney disease. You are taking any other medications, including supplements, traditional medications and herbal remedies.”
HealthHub — Digoxin: common side effects · read 2026-08-27
what it says
“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.”
US FDA label for LANOXIN (digoxin) tablets, Indications and Usage, via openFDA (effective 2024-12-05) · read 2026-08-27
what it says
“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”
US FDA label for LANOXIN tablets, sections 2.1–2.3 Dosage and Administration, via openFDA · read 2026-08-27
what it says
“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”
US FDA label for LANOXIN tablets, section 2.3 Table 3 (recommended maintenance dose by lean body weight and renal function), via openFDA · read 2026-08-27
what it says
“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”
US FDA label for LANOXIN tablets, sections 4–5 Contraindications, Warnings and Precautions, via openFDA · read 2026-08-27
what it says
“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”
US FDA label for LANOXIN tablets, section 7.2 Pharmacokinetic Drug Interactions, via openFDA · read 2026-08-27
what it says
“Digoxin concentrations increased greater than 50%: Amiodarone … Clarithromycin … Dronedarone … Erythromycin … Itraconazole … Propafenone … Quinidine … Ritonavir … Verapamil … Reduce digoxin … by decreasing dose by approximately 30-50%”
US FDA label for LANOXIN tablets, section 7.3 Potentially Significant Pharmacodynamic Drug Interactions, via openFDA · read 2026-08-27
what it says
“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”

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Updated 2026-08-29. Every line above traces to a numbered source. Kozen-X is not a medical device and does not give medical advice. It lists what published sources have written down — nothing more. A pair not listed is unrecorded, not cleared. Before you start, stop or re-time anything, talk to your doctor or pharmacist.

In Singapore

Classification
HSA register

prescription-only

This is the Singapore classification, taken from the HSA register. Dosing stays with the label and your pharmacist or doctor — this page never tells you how much to take.

What the label says

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.

Who should check first

Talk to a doctor or pharmacist before taking this if any of these apply to you.

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

Documented interactions

With medicines and supplements

Amiodarone, dronedarone, quinidine, verapamil, propafenone: FDA: digoxin levels rise more than 50%; levels are measured first and the dose cut by about 30–50%¹⁰
Clarithromycin, erythromycin, itraconazole, ritonavir: FDA: digoxin levels rise more than 50%; monitoring and dose reduction are needed¹⁰
Mirabegron, spironolactone, diltiazem, quinine, ticagrelor: FDA: digoxin levels rise by less than 50%; dose cut by about 15–30% with monitoring¹⁰
Ace inhibitors, arbs, NSAIDs and cox-2 inhibitors: FDA: a fall in gfr or tubular secretion may impair the excretion of digoxin¹¹
Dofetilide or sotalol: FDA: higher rate of torsades de pointes with dofetilide; more proarrhythmic events with sotalol¹¹

Only combinations someone has written down appear here. A pair that is missing is unrecorded, not cleared.