People's Pharmacy

Lanoxin

Generic Name:digoxin

Revised:4/1/2000

Table of Contents

Side Effects and Interactions

Signs of igitalis toxicity include loss of appetite, nausea, diarrhea, vomiting, stomach pain, blurred or disturbed color vision, headache, drowsiness, fatigue, and muscle weakness.

If any of these symptoms occur, contact your physician immediately.

Other adverse reactions may include personality change, depression, confusion, disorientation, apathy, bad dreams and hallucinations. Any side effects should be brought to a doctor's attention promptly.

Lanoxin can interact with a wide range of over-the-counter and prescription medications. Antacids, for example, may diminish the proper absorption of digoxin.

So can certain diarrhea medicines and drugs to control cholesterol like Questran, Cholybar or Colestid.

A number of other medications, such as Cordarone, Rhythmol and quinidine drugs, may make Lanoxin more toxic.

So can Sandimmune, used to prevent transplant rejection.

Calcium-blocking blood pressure medicines like Procardia, Cardizem or Calan may also increase digoxin levels dangerously.

Diuretics like Lasix are often prescribed in conjunction with Lanoxin. A patient taking both medicines should be monitored carefully, however, as the diuretic may make the body lose too much potassium or magnesium. This could lead to serious changes in heart rhythm.

Potassium-sparing diuretics such as Aldactazide or Moduretic could make monitoring and interpreting tests far more complicated.

One of the trickiest interactions is that of Lanoxin with erythromycin and tetracycline. For reasons that are not well understood, about one person in ten harbors bacteria in the gut that metabolizes digoxin. If this intestinal flora is wiped out with an antibiotic, the person may suddenly be exposed to much more Lanoxin than usual, even though they may still be swallowing the exact same dose.

Because of these possible complications, never add any other prescription or over-the-counter medications to Lanoxin without first checking with your pharmacist and physician.

Extracts of the herb hawthorn may increase the activity (but not necessarily the toxicity) of cardiac tonics such as digitalis.

Hawthorn is not recommended for people who are taking Lanoxin or other digoxin medications.

Licorice can greatly increase potassium loss when taking medicines such as Lanoxin; severe potassium loss greatly increases the risk of heart rhythm irregularities in people taking Lanoxin.

The herb cascara sagrada taken with Lanoxin also could result in excessive potassium loss with resulting heart rhythm irregularities.

The herb St. John's wort can speed elimination of digoxin from the body, which could reduce its effectiveness.

Psyllium can affect the absorption of Lanoxin; if you take it, it is best to do so at least an hour after taking Lanoxin.

The herb ma huang is incompatible with cardiac glycosides such as Lanoxin; serious disruption of heart rhythm may occur.

Never stop taking Lanoxin or switch to another brand of digoxin unless your physician is monitoring closely. Because the effective dose is so close to the toxic dose, this might be dangerous.