Indications

Digoxin is indicated in:

Heart failure.
Atrial fibrillation with an uncontrolled ventricular rate.
Acute left ventricular failure.
Chronic left ventricular failure and conjestive heart failure, especially when caused by hypertensive valvular (especially mitral valvular) disease or ischaemic heart disease.

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, spironolactone, erythromycin, clarithromycin (and possibly other macrolide antibiotics) and tetracycline increase digoxin serum level. Besides antacids, kaolinpectin, sulfasalazine, neomycin, penicillamine, calestipol, metoclopramide, rifampin may interfere with intestinal absorption of digoxin resulting low serum concentrations of the drug.

Contraindications

Ventricular fibrillation.
Hypersensitivity to digoxin or other digitalis preparation.

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. Digoxin can be safely used in pregnancy