Digoxin is a Medicine belongs to Cardiovascular drugs group whose information about Brand can be referenced from   Book : Martindale    Page : 1392   Edition : 37  

  ►   Brandname : Digitek, Lanoxin, Cardioxin, Digitek, Lanoxicaps, Sigmaxin, Digosin
  ►  Strength : Tablet with 0.125 mg.  Tablet with 0.25 mg.  Capsule with 0.05 mg.  Capsule with 0.1 mg.  Capsule with 0.2 mg.  Elixir with 0.05 mg/ml.  Injection with 0.1 mg/ml.  Injection with 0.25 mg/ml.  Oral solution with

Reference of this Medicine for its Strength can be taken from   Book : Basic & Clinical pharmacology    Page : 224   Edition : 12   Martindale    Page : 1392   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 : Oral, IV
Reference :-   Book : Martindale    Page : 1391   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 Cardiovascular disorders Oral 125 250 mg Dose: As usual maintenance dose, Given daily
2 Cardiovascular disorders IV infusion 500 1000 micrograms Injection
3 Cardiovascular disorders Oral 750 1500 mcg Dose: initial 24-hour period, either as a single dose, or where there is less urgency or greater risk of toxicity, in divided doses at 6-hourly intervals.

Ref :-  Book : Martindale    Page : 1391   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 Cardiovascular disorders under 1.5 kg Oral 25 micrograms/kg
2 Cardiovascular disorders 1.5 to 2.5 kg Oral 30 micrograms/kg
3 Cardiovascular disorders over 2.5 kg Oral 45 micrograms/kg
4 Cardiovascular disorders 1 Month 2 Year Oral 45 micrograms/kg
5 Cardiovascular disorders 2 Year 5 Year Oral 35 micrograms/kg
6 Cardiovascular disorders Over 10 years Oral 250 500 micrograms
7 Cardiovascular disorders 5 Year 10 Year Oral 25 micrograms/kg

Ref :- Book : Martindale    Page : 1391   Edition : 37  
►  Organ Affected Cardiac disease-( Cardiac dysrhythmia)  

Precaution :- If a Patient is using 'Digoxin' drug in DILATED CARDIOMYOPATHY disease, then Please Use with caution   if he ever suffered from Acute Hepatitis disease.
►  Side Effect : Nausea, Vomiting, Anorexia, Diarrhoea, Abdominal pain, Headache, 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, Sinus bradycardia, AV block, Convulsions
Ref :-   Book : Martindale    Page : 1387   Edition : 37.  

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

  ►    Mechanism of Drug Drug Interaction :  There may be interactions between digoxin 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-digoxin concentrations may be significantly increased by quinidine, amiodarone, dronedarone and propafenone and reduction of digoxin 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 digoxin. Calcium-channel blockers may increase digoxin concentrations. Digoxin is a substrate for P-glycoprotein and interactions may occur with drugs that affect P-glycoprotein function.
Ref :-   Book : Martindale    Page : 1388   Edition : 37.  

►  Absolute Contraindication : Patients with Wolf-Parkinson syndrome or other evidence of an accessory pathway if accompanied by atrial fibrillation.  

►  Contraindication : 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., Digoxin 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, Avoid in patients with hypertrophic obstructive cardiomyopathy unless there is severe cardiac failure, since the outflow obstruction may be worsened
Ref :-   Book : Martindale    Page : 1387-1388   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 :- Thevetia with Another pathway.  

  ►  Pathway with its reference as follows :-
  • Thevetin have Cardio protective effect. --- (PDR for Herbal medicines. (2000) (4th ed.). U.S. )

  •   ►  URL --
  • http://www.travolekar.ru/arch/Pdr_for_Herbal_Medicines.pdf .

  • DIETARY Substance Interactions

    ​   ► This Medicine interact with :- SENNA LEAVES with increase the potency of digoxin .   MAGNESIUM with Decrease in Nutrient Level.   POTASSIUM with Decrease in Nutrient Level.   GINKGO BILOBA with Dietary Substance is Drug Enhancer.   ST JOHNS WORT with Dietary Substance is Drug Inhibitor.  

      ►  Reference :-
  • Driver, S. (2009). Stockleys Herbal Medicines Interactions. Royal pharmaceutical Society of Great Britain: Pharmaceutical press.
  • Duke, J. (2002). Handbook of Medicinal Herbs (2nd ed.). Boca Raton London New York Washington ,D.C.
  • Gaby, A. (2006). A–Z Guide to Drug-Herb-Vitamin Interactions. 2nd ed. New York: Three Rivers Press
  • Michael, Z. (2007). Hand book of nutrition. New York: Thieme Stuttgart

  •   ►  URL -- http://www.crcnetbase.com/doi/pdf/10.1201/9781420040463.fmatt

    ContraIndication DIETARY Substance

    ​   ► This Medicine contraindicate with :- ALFALFA with Digoxin is a substrate for P-glycoprotein .Biochanin A inhibit P- glycoprotein & increase digoxin level ..   LICORICE with Neutralize the medicine blood pressure lowering effect ..  

      ►  Reference :-
  • Driver, S. (2009). Stockleys Herbal Medicines Interactions. Royal pharmaceutical Society of Great Britain: Pharmaceutical press.
  • Eldelberg, D. The New Age of nutritional and herbal remedies. New Zealand

  •   ►  URL -- https://www.stonybrookmedicine.edu/sites/default/files/herbal_medicines_interactions-1.pdf

    ►   Route of Elimination :   Renal
    Ref :-   Book : Martindale    Page : 1390   Edition : 37.  

    ►    Plasma Half-life :   Min value :-   1.5 days,    Max value :-   2 Days.  
    Ref :-   Book : Martindale    Page : 1390   Edition : 37.  

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