Agoxin (Digoxin)
Description
Digoxin is a cardiac glycoside used in the management of particularly atrial fibrillation and in heart failure. The principal actions of digoxin are an increase in the force of myocardial contraction (positive inotropic activity) and a reduction in the conductivity of the heart particularly in conduction through the atrioventricular (AV) +node. Digoxin also has a direct action on vascular smooth muscle and indirect effects mediated primarily by the autonomic nervous system and particularly by an increase in the vagal activity.
Presentation
Agoxin Tablet: Each tablet contains Digoxin BP 0.25 mg.
Indications
- Heart failure
- Atrial fibrillation with an uncontrolled ventricular rate
- Acute left ventricular failure
- Chronic left ventricular failure and congestive heart failure, especially when caused by hypertensive valvular (especially mitral valvular) disease or ischaemic heart disease.
Dosage & Administration
For rapid action 1-1.5 mg in divided doses over 24 hours for less urgent digitalisation 0.25-0.5 mg daily(higher dose may be divided); Maintenance: 0.0625 – 0.5 mg daily (higher dose may be divided) accordingly to renal function and in atrial fibrilation on heart rate response; usual range: 0.125-0.25 mg daily (lower dose my be appropriate in elderly).
Contrainidications
Ventricular fibrillation and hypersensitivity to digoxin or other digitalis preparation.
Warning & Precautions
Side effects
Usually associated with excessive dosage include anorexia, nausea, vomiting, diarrhoea, abdominal pain, visual disturbance, headache, fatigue, drowsiness, confusion, delirium, hallucination, depression, arrhythmia, heart block, intestinal ischaemia, gynaecomastia on long term use, thrombocytopenia reported.
Drug interaction
Potassium-depleting diuretics increase the effects of digitalis. Calcium particularly if administered rapidly by the intravenous route may produce serious arrhythmia in digitalized patients. Quinidine, verapamil, amiodarone, propafenone, indomethacin, itraconazole, alprazolam and spironolactone, erythromycin, clarithromycin (and possibly other macrolide antibiotics) and tetracycline increase digoxin serum level. Besides antacids, kaolin-pectin, sulfasalazine, neomycin, penicillamine, calestipol, metoclopramide, rifampin may interfere with intestinal absorption of digoxin resulting low serum concentrations of the drug.
Use in special groups
Use during pregnancy: Digoxin can be used.
Use in children & neonates: Digoxin can be used.
Use during lactation: Digoxin is excreted in breast milk but in concentration below those found in plasma and therefore poses no hazard to the breast-feed infant.
Use in elderly: Partly because of reduced renal function and partly because of their tissues are more sensitive to the effects of digitalis, the elderly require lower maintenance dose of digoxin than younger adults.
Packing
Agoxin Tablet: Each box contains 100’s tablets in blister pack.
