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Indications and Dosage
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. |
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Renal Impairment
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Contraindications
Wolff-Parkinson-White syndrome; hypertrophic obstructive cardiomyopathy.
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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.
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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. |
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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. |
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Action
Description:
Mechanism of Action: 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. |
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MIMS Class
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