Digitoxin is a Medicine belongs to Cardiovascular drugs group whose information about Brand can be referenced from   Book : Martindale    Page : 1387   Edition : 37  

  ►   Brandname : Coramedan, Digimed, Digimerck, Crystodigin.
  ►  Strength : Tablet with .  Injection with

Reference of this Medicine for its Strength can be taken from   Book : Martindale    Page : 1387   Edition : 37  
A Route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. Common examples include oral and intravenous administration.

  ►  Route of administration : Slow IV, Oral
Reference :-   Book : Martindale    Page : 1387   Edition : 37  

Dosing of Medicine differ in Adult & Pediatrics ↓

Adult Dose

S.No Ailment   Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency   Additional Info
1 Management of some cardiac arrhythmias and in heart failure Oral 1 1.5 mg Tablet Dose Given in divided doses over 24 hours for rapid digitalisation, while for slow digitalisation an oral dose of 200 micrograms twice daily for 4 days has been given. The usual maintenance dose is 100 to 200 micrograms daily, but 100 micrograms on alternate days may be adequate. Digitoxin may also be given by slow intravenous injection when vomiting or other conditions prevent oral use; maintenance doses of 70 to 100 micrograms daily have been used.

Ref :-  Book : Martindale    Page : 1386   Edition : 37  

Pediatric Dose

S.No Ailment   Age Min   Age Max   Weight ( Kg ) Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency  Additional Info  
1 Management of some cardiac arrhythmias and in heart failure 20 mcg/kg

Ref :- Book : Martindale    Page : 1387   Edition : 37  
►  Side Effect : Nausea, Vomiting, Anorexia, Diarrhoea, Abdominal pain, Headache, Facial pain, Fatigue, Weakness, Dizziness, Drowsiness, Disorientation, Mental confusion, Bad dreams, Thrombocytopenia, Gynaecomastia, Hypertension, Blurred Vision, Heart failure, Supraventricular or ventricular arrhythmias and defects of conduction, AV junctional tachycardia, Atrial tachycardia with block, Extrasystoles, Sinoatrial block, AV block, Convulsions
Ref :-   Book : Martindale    Page : 1386, 1387   Edition : 37.   Martindale    Page : 1387   Edition : 37.  

►  Drug Interaction : Drug interaction of Digitoxin is with Thiazide Diuretics , Loop Diuretics , Beta Blockers , Calcium Channel Blockers , ,  Rifampicin , Phenobarbital , Quinidine , Amiodarone , Dronedarone, Propafenone
Ref :-   Book : Martindale    Page : 1386, 1388   Edition : 37.  

  ►    Mechanism of Drug Drug Interaction :  Since digitoxin is significantly metabolized in the liver it may be affected by drugs that induce microsomal enzymes, including rifampicin and antiepileptics such as phenobarbital. There may be interactions between digitoxin and drugs that alter its absorption, interfere with its excretion, or have additive effects on the myocardium. Drugs that cause electrolyte disturbances increase the risk of toxicity from cardiac glycosides. Thiazides and loop diuretics cause hypokalaemia and also hypomagnesaemia which may lead to cardiac arrhythmias. Serum- digitoxin concentrations may be significantly increased by quinidine, amiodarone, dronedarone and propafenone and reduction of digitoxin dosage may be required. Other antiarrhythmics may have additive effects on the myocardium increasing the likelihood of adverse effects; beta blockers may potentiate bradycardia due to digitoxin. Calcium-channel blockers may increase digitoxin concentrations. Digitoxin is a substrate for P-glycoprotein and interactions may occur with drugs that affect P-glycoprotein function.
Ref :-   Book :    Page : 1386,1388   Edition : 37.  

►  Contraindication : Avoid in patients with hypertrophic obstructive cardiomyopathy unless there is severe cardiac failure, since the outflow obstruction may be worsened, Avoid in in patients with the Wolff-Parkinson-White syndrome or other evidence of an accessory pathway, especially if it is accompanied by atrial fibrillation, since ventricular tachycardia or fibrillation may be precipitated., Digitoxin should be used with caution in partial heart block since complete heart block may be induced; it should also be used with care in sinus node disorders, Caution is also required in acute myocarditis (such as rheumatic carditis), in acute myocardial infarction, in advanced heart failure, and in severe pulmonary disease, due to the increased myocardial sensitivity
Ref :-   Book : Martindale    Page : 1386, 1387   Edition : 37.  
  ►  Mechanism of Action :   In myocardium, inhibit plasma membrane Na+/K+ -ATPase, leading to increased cytoplasmic Ca+ concentration, which result in positive inotropic; (2) in autonomic nervous system, inhibit sympathetic outflow and increase parasympathetic (vagal) tone; (3) at AV node, prolong effective refractory period and slow conduction velocity Digoxin immune Fab is an antibody fragment that bind to and inhibit digoxin.
Ref :-   Book : Principle of Pharmacology (The Pathophysiologic Basis of Drug Therapy)    Page : 434   Edition : 3.  

Pathway of DIETARY Product

​   ► Act.Comp / Nutrient / Food / Herb as follows :- NA

DIETARY Substance Interactions

​   ► This Medicine interact with :- NA

ContraIndication DIETARY Substance

​   ► This Medicine contraindicate with :- LICORICE with Neutralize the medicine blood pressure lowering effect ..   FRANGULA I.E. RHAMNUS FRANGULA with frangula interact with carticosteroid ..  

  ►  Reference :-
  • Eldelberg, D. The New Age of nutritional and herbal remedies. New Zealand
  • Williamson, E. (2009). Stockley's Herbal Medicines Interaction .. London: Pharmacutical press.

  •   ►  URL -- https://books.google.co.in/books?id=WZhj8EO9N3sC&pg=PA49&lpg=PA49&dq=The+New+Age+of+nutritional+and+herbal+remedies.++book&source=bl&ots=UVld-vNZL0&sig=5KwkKUUvW45p0TkfVUCtMZxnbow&hl=en&sa=X&ved=0ahUKEwiajLCNocrOAhVMto8KHfD2D-4Q6AEIMDAE#v=onepage&q=The%20

    ►   Route of Elimination :   Hepatic (Metabolism), Renal, Faecal
    Ref :-   Book : Martindale    Page : 1386   Edition : 37.  

    ►    Plasma Half-life :   Min value :-   upto 7 days or more,    Max value :-   NA
    Ref :-   Book : Martindale    Page : 1386   Edition : 37.  

    ►    Peak Plasma Concentration :   Min value :-   NA    Max value :-   NA