Digitoxin


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Cardiac arrhythmias; Heart failure Rapid digitalisation: 600 mcg, followed by 400 mcg 4-6 hr later then 200 mcg 4-6 hrly as necessary. Slow digitalisation: 200 mcg twice daily for 4 days. Maintenance: 50-300 mcg once daily.
Dosage Details
Oral
Cardiac arrhythmias, Heart failure
Adult: Rapid digitalisation: 600 mcg followed by 400 mcg after 4-6 hr then 200 mcg every 4-6 hr as necessary. Slow digitalisation: 200 mcg bid for 4 days. Maintenance: 50-300 mcg once daily (usual dose: 150 mcg daily).
Child: 20 mcg/kg.
Renal Impairment
CrClDosage
<1050-75% of the normal dose.
Contraindications
Wolff-Parkinson-White syndrome; hypertrophic obstructive cardiomyopathy.
Special Precautions
CV disease; partial heart block, sinus node disorders, acute myocarditis, acute MI, advanced heart failure, severe pulmonary disease, thyroid dysfunction, hypokalaemia, hypomagnesaemia, hypercalcaemia, hypoxia, hypothyroidism, impaired renal function, elderly, premature infants. Maintain heart rate >60 beats/minute. withdraw 1-2 days before undergoing cardioversion. Not an appropriate form of therapy for any ventricular arrhythmia. Pregnancy.
Adverse Reactions
Nausea, vomiting, anorexia, diarrhoea, abdominal pain, headache, facial pain, fatigue, weakness, dizziness, drowsiness, disorientation, mental confusion, bad dreams, delirium, acute psychoses, hallucinations, convulsions, blurred vision, color vision may be affected, gynecomastia, vasoconstriction, and transient hypotension (rapid IV inj), local irritation (SC/IM), hypersensitivity reactions, thrombocytopenia.
Potentially Fatal: Heart failure, supraventricular or ventricular arrhythmias, conduction defects.
Drug Interactions
Thiazides, loop diuretics; corticosteroids; β2-agonists, amphotericin B; sodium polystyrene sulfonate; carbenoxolone; IV admin of calcium salts; quinidine; amiodarone; propafenone; other antiarrhythmics; β-blockers; calcium-channel blockers. Increased hepatic clearance by enzyme inducers e.g. rifampicin and aminoglutethimide.
Potentially Fatal: Reduce dose of digitoxin when there is hypokalaemia, hypomagnesaemia, hypercalcaemia, hypoxia, or hypothyroidism.
Action
Description: Digitoxin is a cardiac glycoside with +ve inotropic activity.
Onset: 2-12 hr.
Duration: 3 wk.
Pharmacokinetics:
Absorption: Readily and completely absorbed from the GI tract.
Distribution: 90% bound to plasma proteins.
Metabolism: Metabolised in the liver. Enterohepatic recycling occurs.
Excretion: Excreted in urine, mainly as metabolites. Elimination half-life of up to 7 days or more.
MIMS Class
Disclaimer: This information is independently developed by MIMS based on Digitoxin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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