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Lanoxin (digoxin) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat mild to moderate heart failure in adults and improve heart contractions in children with heart failure.
These insights are based on 144 comments about Lanoxin from MyHeartDiseaseTeam members. These are the experiences of a small number of people and are not meant to be medical advice.
Benefits:
Considerations:
Lanoxin is a cardiac glycoside. It blocks a cell pump called sodium-potassium ATPase. This raises calcium inside heart muscle cells and helps the heart squeeze more strongly. It also slows some electrical signals in the heart. This can help control the resting heart rate in adults with chronic atrial fibrillation.
Doctors may prescribe Lanoxin to treat mild to moderate heart failure in adults, strengthen heart contractions in children with heart failure, or control the resting heart rate in adults with chronic atrial fibrillation. In adults with heart failure, it may improve symptoms and exercise ability. It may also reduce heart failure-related hospital stays and emergency care. It has not been shown to help people live longer.
Lanoxin comes as a tablet taken by mouth and as an injection into a vein or muscle. The injection is used when rapid treatment is needed or when the medicine cannot be taken by mouth. Injection into a vein is preferred because injection into a muscle can cause severe pain. The intravenous (IV) dose is given slowly over at least five minutes. It should not be given as a rapid bolus.
Some people start with a loading dose, followed by maintenance doses. Others start with maintenance dosing only. The dose depends on age, lean body weight, kidney function, other medicines, treatment response, signs of toxicity, and digoxin blood levels.
For Lanoxin tablets, the recommended total oral loading dose for adults and children older than 10 years is 10 to 15 micrograms per kilogram. Half of the total dose is given first. One-quarter of the total dose is then given every six to eight hours for two more doses. The recommended starting maintenance dose is 3.4 to 5.1 micrograms per kilogram once daily.
For Lanoxin injection, the recommended total intravenous loading dose for adults and children older than 10 years is 8 to 12 micrograms per kilogram. Half of the total dose is given first. One-quarter of the total dose is then given every six to eight hours for two more doses. The recommended starting IV maintenance dose is 2.4 to 3.6 micrograms per kilogram once daily.
Children need doses based on their age, lean body weight, and kidney function. Digoxin solution may be used for infants, young children, or people with very low body weight when tablets cannot provide the correct dose.
Maintenance doses may be increased every two weeks based on treatment response, digoxin blood levels, and signs of toxicity. Doses may also need to be changed based on kidney function. Oral and injected doses are not equal because the body absorbs them differently.
This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.
These insights are based on 144 comments about Lanoxin from MyHeartDiseaseTeam members.
Members who use Lanoxin often talk about balancing symptom relief with careful monitoring. Across the community, many say it helps to stay in close contact with a cardiologist, watch for side effects or heart rate changes, and ask about possible interactions with other medicines or supplements.
Get blood work when your doctor orders it.
“To all my fellow heart failure friends, if you are taking digoxin be aware of the side effects. If you have been taking it and you have not had blood drawn to check the levels in your system, tell your doctor.”
Tell your doctor about side effects that might need dose adjustment.
“There are side effects and it’s tricky to regulate. Tell your cardiologist about your side effects; he might adjust the dosage.”
Ask about interactions with other medicines and supplements.
“I would suggest asking your doctor about how your other meds might be interacting with the digoxin. I stopped taking the supplements after surgery because my doctor said it would interfere with my heart medication.”
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In clinical studies, the side effects of Lanoxin occurred in about 5 percent to 20 percent of people. These include:
Lanoxin can cause serious side effects that may require immediate medical attention. These include:
Get medical help right away if you think you are having a serious reaction.
Tell your doctor if you are allergic to digoxin or have had a reaction to another digitalis medicine. Signs may include an unexplained rash, swelling of the mouth, lips, or throat, or trouble breathing.
Before treatment, tell your doctor if you have:
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Many medicines can change digoxin levels or raise the risk of a slow or abnormal heartbeat. Your doctor may check your digoxin blood level or change your dose.
Tell your healthcare team that you take Lanoxin before electrical cardioversion. Your doctor may lower or stop the dose for one to two days before the procedure because it may trigger dangerous heart rhythms.
Do not take Lanoxin if you have ventricular fibrillation or a known allergy to digoxin.
Older adults and people with kidney problems need careful dose selection and closer monitoring because digoxin leaves the body mainly through the kidneys.
If you are pregnant, planning to become pregnant, or breastfeeding while taking Lanoxin, talk with your doctor about the risks and benefits. Digoxin crosses the placenta, and dose needs may change during pregnancy and after delivery. Your doctor may check your digoxin blood level.
A newborn may also need monitoring for vomiting or abnormal heart rhythms. Only a small amount of digoxin passes into breast milk, and this amount is unlikely to cause an important effect in most nursing infants.
These answers are fact-checked by our editorial staff.
How effective is Lanoxin for heart failure?
In two studies lasting 12 weeks, adults who continued taking Lanoxin were better able to maintain their exercise ability. They were also less likely to have worsening heart failure, heart failure-related hospital stays, emergency care, or the need for additional treatment.
The DIG trial included 6,800 adults with heart failure and a left ventricular ejection fraction of 45 percent or less. Compared with placebo, digoxin lowered the number of heart failure hospitalizations by about 25 percent. It also lowered the chance of having at least one heart failure hospitalization by about 28 percent. However, digoxin did not help people live longer.
Lanoxin is also used to control resting heart rate in adults with chronic atrial fibrillation. It can lower heart rate at rest, but it does not significantly lower heart rate during exercise. It is not used to reliably change recent-onset atrial fibrillation back to a normal rhythm.
Lanoxin comes as tablets and as an injection. The injection is used when rapid treatment is urgently needed or when the medicine cannot be taken by mouth.
How long does Lanoxin take to work?
Lanoxin tablets usually start working within 30 minutes to two hours. The strongest effect is usually reached within two to six hours. After a dose by mouth, digoxin blood levels usually peak within one to three hours.
Lanoxin injection usually starts working within five to 30 minutes. The strongest effect is usually reached within one to four hours.
What tests or monitoring are needed with Lanoxin?
Your doctor will check for signs of digoxin toxicity and whether the medicine is working. Blood tests may be used to measure digoxin levels and help guide treatment. The blood sample should be taken just before the next dose or at least six hours after the last dose.
People taking Lanoxin should also monitor and record their heart rate and blood pressure each day. Kidney function is important because it affects how digoxin leaves the body and may change the dose needed.
Can Lanoxin cause blurred vision or confusion in people taking it for heart disease?
Yes. Lanoxin can cause blurred vision and other vision changes. It can also cause confusion, headache, weakness, dizziness, apathy, anxiety, depression, delirium, or hallucinations.
Nausea, vomiting, ongoing diarrhea, confusion, weakness, or vision changes may mean the dose is too high. Contact a doctor or healthcare professional if these symptoms happen.
On MyHeartDiseaseTeam, people share their experiences with heart disease, get advice, and find support from others who understand.
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