Digoxin Tablets Bp 0.25mg Tablet

What is Digoxin Tablets Bp 0.25mg Tablet?

Digoxin Tablets BP 0.25 mg are an oral cardiac medicine containing digoxin, a cardiac glycoside. Digoxin is used in selected patients for the management of certain heart conditions, including heart failure and some supraventricular arrhythmias. The 0.25 mg tablet provides digoxin for oral administration under appropriate clinical supervision.

Uses / Indications

Digoxin 0.25 mg tablets may be used in the management of selected cardiovascular conditions, including:

• Heart failure in appropriate patients
• Certain supraventricular arrhythmias
• Atrial fibrillation
• Atrial flutter

The specific indication, treatment objective and suitability depend on the patient’s cardiovascular condition and the approved product information.

Benefits

• Provides the cardiac glycoside digoxin in an oral tablet formulation.
• Increases the force of cardiac contraction through its pharmacological action.
• Can reduce ventricular rate in certain supraventricular arrhythmias.
• May be incorporated into treatment regimens for selected patients with heart failure.
• Provides a 0.25 mg strength for oral administration when clinically appropriate.

Side Effects

Common Side Effects

Possible adverse effects may include:

• Nausea
• Vomiting
• Diarrhoea
• Abdominal discomfort
• Headache
• Dizziness
• Fatigue
• Visual disturbances

Less Common or Serious Side Effects

Digoxin has a relatively narrow therapeutic range, and excessive exposure can result in toxicity. Clinically important adverse effects may include:

• Bradycardia
• Other cardiac rhythm disturbances
• Palpitations
• Confusion
• Severe dizziness
• Significant visual disturbances
• Loss of appetite
• Nausea and vomiting associated with toxicity

Medical attention should be sought if symptoms suggestive of digoxin toxicity or significant cardiac rhythm disturbance occur.

How Does It Work?

Digoxin

Digoxin inhibits the sodium-potassium ATPase enzyme in cardiac muscle cells. This increases intracellular sodium and indirectly increases intracellular calcium, resulting in increased cardiac contractility.

Digoxin also increases vagal activity and influences conduction through the atrioventricular node. This can help reduce ventricular rate in certain supraventricular arrhythmias, including atrial fibrillation and atrial flutter.

Dosage Guidelines

Digoxin has a narrow therapeutic range, so dosage must be individualised according to the clinical indication, age, body weight, renal function, concomitant medicines and response to treatment.

The exact dose and treatment duration should follow the approved product information and the recommendation of a qualified healthcare professional.

For oral tablets:

• Take exactly as prescribed.
• Take the tablet at approximately the same time each day where directed.
• Swallow with sufficient water unless otherwise directed.
• Do not alter the prescribed dose.
• Do not take additional doses if a dose is missed unless specifically instructed.
• Blood levels and clinical parameters may require monitoring in appropriate patients.

When Not to Use

Digoxin should generally not be used in patients with:

• Known hypersensitivity to digoxin or any component of the formulation
• Certain significant ventricular arrhythmias
• Some forms of heart block or conduction disorders unless appropriately managed
• Certain conditions where digoxin is clinically inappropriate

Particular caution may be required in patients with electrolyte abnormalities, renal impairment, thyroid disorders or a history of cardiac rhythm disturbances.

The approved product information should be consulted for complete contraindications and warnings.

Drug / Product Interactions

Clinically important interactions may occur with medicines that affect digoxin absorption, distribution, elimination or cardiac effects.

Relevant medicines and categories include:

• Amiodarone
• Verapamil
• Certain calcium-channel blockers
• Macrolide antibiotics
• Some antiarrhythmic medicines
• Diuretics that may cause potassium or magnesium depletion
• Other medicines affecting renal function
• Medicines that may alter gastrointestinal absorption or intestinal transport of digoxin

Low potassium or magnesium levels may increase susceptibility to digoxin toxicity.

Patients taking multiple medicines should inform their healthcare professional before starting digoxin.

Safety Advice

Overdose

If an overdose is suspected, seek immediate medical attention or contact an appropriate poison-control or emergency medical service.

Digoxin overdose can be serious because of its narrow therapeutic range and potential to cause cardiac arrhythmias.

Missed Dose

Take the missed dose when remembered unless it is nearly time for the next scheduled dose. If the next dose is due soon, skip the missed dose and continue with the regular schedule. Do not double the next dose.

Driving

Digoxin may cause dizziness, visual disturbances or other symptoms in some patients. Patients experiencing such effects should avoid driving or operating machinery and seek appropriate medical advice.

Pregnancy

Digoxin may be used during pregnancy when clinically indicated and under appropriate medical supervision. The potential benefits and risks should be assessed by a qualified healthcare professional.

Breastfeeding

Digoxin passes into breast milk in small amounts. Its use during breastfeeding should be based on appropriate clinical assessment.

Children

Paediatric dosing requires individual calculation based on factors such as age, body weight, renal function and clinical indication. Use in children should follow specialist or approved product information.

Elderly Patients

Older patients may have an increased risk of digoxin accumulation, particularly when renal function is reduced. Appropriate dose selection and monitoring may be required.

Renal Impairment

Digoxin is substantially eliminated by the kidneys. Patients with impaired renal function may require dose adjustment and closer monitoring to reduce the risk of accumulation and toxicity.

Electrolyte Abnormalities

Low potassium or magnesium levels can increase the risk of digoxin toxicity. Electrolyte abnormalities should be identified and appropriately managed by a healthcare professional.

General Instructions

• Take digoxin exactly according to the prescribed schedule.
• Swallow the tablet with sufficient water unless otherwise directed.
• Take doses consistently at the prescribed time.
• Do not change the dose without professional advice.
• Do not take an additional dose to compensate for a missed dose.
• Inform healthcare professionals that you are taking digoxin before starting other medicines.
• Follow any recommended blood tests or clinical monitoring.
• Keep the medicine in its original packaging where appropriate.
• Do not share prescription medicines with other people.

Special Dietary / Lifestyle Tips

No specific dietary restriction is generally required unless advised by a healthcare professional.

Maintain a consistent diet and discuss significant changes in dietary potassium intake with a healthcare professional, particularly when taking medicines that affect electrolyte levels.

Avoid self-treatment with potassium or electrolyte supplements unless recommended by a healthcare professional.

Comparison with Other Treatments

Digoxin is a cardiac glycoside with positive inotropic and vagally mediated effects. Other medicines used in heart failure or supraventricular arrhythmias, such as beta-blockers, certain calcium-channel blockers and other cardiovascular medicines, have different mechanisms and clinical roles.

Treatment selection depends on the underlying cardiovascular condition, heart rhythm, renal function, other medicines, electrolyte status and individual clinical requirements.

Precautions & Warnings

• Digoxin has a narrow therapeutic range and requires careful dose selection.
• Renal function should be considered when determining the appropriate dose.
• Monitor for symptoms that may indicate digoxin toxicity.
• Electrolyte abnormalities, particularly low potassium or magnesium, can increase toxicity risk.
• Use cautiously in patients with cardiac conduction abnormalities.
• Inform healthcare professionals about all other medicines being taken.
• Additional monitoring may be appropriate when starting or stopping medicines known to interact with digoxin.
• Elderly patients may require particular attention to renal function and dosing.
• Seek urgent medical attention for severe dizziness, fainting, significant visual changes, palpitations or suspected overdose.

Can I Use It With Other Medicines?

Generally Compatible With

Digoxin can be used alongside other cardiovascular medicines when specifically prescribed and appropriately monitored. The complete medication profile should be reviewed because several medicines can alter digoxin exposure or cardiac effects.

Use With Caution / Avoid

Particular caution may be required with:

• Amiodarone
• Verapamil
• Certain calcium-channel blockers
• Macrolide antibiotics
• Other antiarrhythmic medicines
• Diuretics that can reduce potassium or magnesium levels
• Medicines that affect renal function
• Other medicines known to alter digoxin concentrations

Do not start, stop or change other medicines without appropriate medical advice.

Storage

Store according to the storage conditions stated on the approved product label and package insert.

• Keep properly closed.
• Protect from excessive heat.
• Protect from moisture.
• Keep out of reach of children.
• Do not use after the expiry date.
• Keep in the original packaging where appropriate.

Frequently Asked Questions

1. What is Digoxin 0.25 mg Tablet used for?

Digoxin 0.25 mg Tablets are used in selected patients for the management of certain heart conditions, including heart failure and some supraventricular arrhythmias such as atrial fibrillation.

2. What is the active ingredient in Digoxin Tablets BP 0.25 mg?

The active ingredient is digoxin 0.25 mg per tablet.

3. How does Digoxin 0.25 mg work?

Digoxin increases the force of cardiac contraction and influences electrical conduction through the atrioventricular node. These effects contribute to its role in selected heart failure and heart rhythm conditions.

4. Why does Digoxin require careful dosing?

Digoxin has a narrow therapeutic range, meaning the difference between an appropriate therapeutic exposure and potentially toxic exposure can be relatively small. Dose selection may depend particularly on renal function, age, body weight and other medicines.

5. What are possible signs of Digoxin toxicity?

Possible signs include nausea, vomiting, loss of appetite, dizziness, visual disturbances, confusion and abnormal heart rhythms. Suspected toxicity requires prompt medical assessment.

6. Can Digoxin 0.25 mg be used in patients with kidney problems?

Patients with renal impairment may require dose adjustment and closer monitoring because digoxin is substantially eliminated through the kidneys.

7. What should I do if I miss a dose of Digoxin?

Take the missed dose when remembered unless it is close to the next scheduled dose. If the next dose is due soon, skip the missed dose. Do not double the next dose.

8. How should Digoxin 0.25 mg Tablets be stored?

Store the product according to the conditions stated on the approved product label and package insert. Keep it protected from excessive heat and moisture and out of reach of children.