Common questions about digoxin - Brand name: Lanoxin

Digoxin is a type of medicine called a cardiac glycoside.

It slows your heart rate and makes your heart beat stronger. This makes it easier for the heart to pump blood around your body which helps your heart work better.

It can take several weeks for digoxin to start working and you will not feel better straight away.

Do not stop taking digoxin suddenly, as this could make your heart problems worse. If you have any side effects or concerns, speak to your doctor.

If you have atrial fibrillation, or certain heart problems such as arrhythmia, you may notice improvements after a few weeks.

If you have atrial fibrillation, the following symptoms may mean that digoxin is not working as well as it could be:

• a fast pulse
• a fast heartbeat or you can feel your heartbeat (palpitations)
• you feel dizzy or faint or have fainted

If you have heart failure, the following symptoms may mean that digoxin is not working as well as it could be:

• more shortness of breath than usual
• you cannot climb stairs or walk as easily as usual
• you are waking up short of breath at night, or you need more pillows than usual
• you need to pee more at night
• your ankles look swollen or your shoes feel too tight

If you get any of these symptoms, your doctor will advise you how to change your dose.

Digoxin is a very effective medicine, but it can have serious side effects. It's important to take it as your doctor has recommended.

It's safe to take as long as the benefits of taking it are greater than the risks. Your doctor will help you decide this.

Your doctor will check your dose is right and you'll be asked to have blood tests.

It's important to let your doctor know if you have any new symptoms or symptoms that get worse.

You'll have regular blood tests to check that your kidneys are healthy. The kidneys remove digoxin from your body, so it's important they work properly.

Your blood test may also check that you have the right amounts of potassium, magnesium and calcium in your blood. If there's too much or too little of these in your blood it can affect how digoxin works.

The dose of digoxin is important as too little will not help, but too much can cause side effects. To make sure your dose is right, you doctor will ask you to have a blood test.

This must be done at least 6 hours after your last dose of digoxin, so you'll need to tell your doctor or nurse when you normally take your digoxin.

They may want you to wait to take your dose or they may schedule your appointment so that you will have your blood taken at the right time.

Talk to your doctor if you want to stop taking digoxin. Stopping digoxin suddenly can make your condition worse.

If you have side effects, it's important that you talk to your doctor about this. Your doctor may be able to prescribe a different medicine for your heart problems.

If you stop taking digoxin, it will take about 8 days for it to be completely out of your body. It could take longer if you have kidney problems.

Digoxin is a type of medicine called a cardiac glycoside and it's the only medicine of its kind.

Digoxin is used much less commonly now than in the past because newer, more effective medicines for heart failure and certain heart problems, such as arrhythmia and atrial fibrillation, are now available.

Some of the main medicines for heart failure include:

• angiotensin converting enzyme (ACE) inhibitors such as ramipril or lisinopril
• angiotensin receptor blockers (ARBs) such as valsartan
• beta blockers
• spironolactone or eplerenone
• medicines which make you pee more (diuretics) such as furosemide
• ivabradine, sacubitril, and hydralazine with nitrate

Some of the medicines which help to control your heart rate include:

• beta blockers, such as bisoprolol or atenolol
• calcium channel blockers, such as verapamil or diltiazem

They all work differently to digoxin and the side effects can also be different.

Your heart specialist might prescribe digoxin for you to use alongside your other heart medicines when these are not enough to manage your symptoms.

You may need to try a few different medicines before you find a combination that controls your symptoms but does not cause unpleasant side effects.

If you need an operation or other treatment, make sure you tell your doctors, nurses and pharmacist that you are taking digoxin. They'll tell you whether you need to stop taking it.

Some medicines used during certain surgical procedures (such as suxamethonium and pancuronium) can affect the way digoxin works.

Digoxin will not affect any type of contraception.

Some types of hormonal contraception, such as the combined pill and contraceptive patch, are not usually recommended for women with heart problems.

Talk to your doctor if you're taking hormonal contraception.

If digoxin makes you vomit or have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.

Find out more:

• What to do if you're sick or have diarrhoea when taking the combined pill
• What to do if you're sick or have diarrhoea when taking the progestogen-only pill

There's nothing to suggest digoxin can affect your sex life.

If you're having problems with your sex life, talk to your doctor.

You can drive or ride a bike if you feel OK when taking digoxin.

However, if you feel dizzy or unwell or have any problems with your vision such as blurred vision, do not drive a car, ride a bike, or use tools or machinery.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking digoxin. GOV.UK has more information on the law on drugs and driving.

It's a good idea not to drink alcohol when you first start taking digoxin, or after a dose increase, until you see how the medicine affects you.

If you find digoxin makes you feel dizzy, it's best to stop drinking alcohol.

You can eat normally while taking digoxin.

Eating a healthy, balanced diet can help if you have a heart condition.

You can boost the health of your heart by making some key lifestyle changes.

• Quit smoking – smoking increases your heart rate and blood pressure. Quitting smoking brings down your blood pressure and relieves heart failure symptoms. Try to avoid second-hand smoke.
• Cut down on alcohol – it's a good idea to not drink alcohol when you first start taking digoxin, or after a dose increase, until you see how the medicine affects you. If you find digoxin makes you feel dizzy, it's best to stop drinking alcohol. If you do drink, keep to the recommended guidelines of no more than 14 units of alcohol a week, spread over 3 or more days. A medium glass of wine (175ml) is 2 units. A pint of lager or beer is usually 2 to 3 units of alcohol.
• Exercise – regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. It does not need to be too energetic, walking every day will help.
• Eat well – aim to eat a diet that includes plenty of fruit and vegetables, wholegrains, fat-free or low-fat dairy products and lean proteins. It's a good idea to follow these tips for a lower salt diet too. Eating too much salt is the biggest cause of high blood pressure. The more salt you eat, the higher your blood pressure will be. Aim for no more than 6g of salt a day.
• Manage stress – when you're anxious or upset, your heart beats faster, you breathe more heavily and your blood pressure often goes up. This can make heart failure worse too. Find ways to reduce stress in your life. To give your heart a rest, try napping or putting your feet up when possible. Spend time with friends and family to be social and help avoid stress.