Buy Lanoxin Online

What is Lanoxin?

Lanoxin (digoxin) is derived from the leaves of a digitalis plant. Digoxin helps make the heart beat stronger and with a more regular rhythm.

Lanoxin is used to treat heart failure.

Lanoxin is also used to treat atrial fibrillation, a heart rhythm disorder of the atria (the upper chambers of the heart that allow blood to flow into the heart).

Digoxin may also be used for purposes not listed in this medication guide.

Important information about Lanoxin

You should not use Lanoxin if you are allergic to digoxin, or if you have ventricular fibrillation (a heart rhythm disorder of the ventricles, or lower chambers of the heart that allow blood to flow out of the heart).

Before using Lanoxin, tell your doctor if you have certain heart conditions, especially "AV block" (unless you have a pacemaker), or a recent history of heart attack. Also tell your doctor if you have kidney disease, a thyroid disorder, an electrolyte imbalance (such as low levels of calcium, potassium, or magnesium in your blood), or if you are malnourished or have recently been sick with vomiting or diarrhea.

Keep taking Lanoxin as directed, even if you feel well. Get your prescription refilled before you run out of medicine completely.

Do not stop taking Lanoxin without first talking to your doctor. Stopping suddenly may make your condition worse.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Lanoxin overdose can occur more easily if you are dehydrated.

There are many other drugs that can interact with Lanoxin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Before taking Lanoxin

You should not use Lanoxin if you are allergic to digoxin, or if you have ventricular fibrillation (a heart rhythm disorder of the ventricles, or lower chambers of the heart that allow blood to flow out of the heart).

To make sure you can safely take Lanoxin, tell your doctor if you have any of these other conditions:

  • certain serious heart conditions, especially "AV block" (unless you have a pacemaker);

  • a recent history of heart attack;

  • kidney disease;
  • a thyroid disorder;

  • an electrolyte imbalance (such as low levels of calcium, potassium, or magnesium in your blood); or

  • if you are malnourished or have recently been sick with vomiting or diarrhea.

FDA pregnancy category C. It is not known whether Lanoxin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Digoxin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults may be more likely to have side effects from Lanoxin.

How should I take Lanoxin?

Take Lanoxin exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Take Lanoxin with a full glass of water.

Try to take the medication at the same time every day.

To be sure this medication is not causing harmful effects, your blood may need to be tested on a regular basis. Your kidney function may also need to be tested. Do not miss any scheduled appointments.

Keep taking Lanoxin as directed, even if you feel well. Get your prescription refilled before you run out of medicine completely.

Do not stop taking Lanoxin without first talking to your doctor. Stopping suddenly may make your condition worse.

Store Lanoxin at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If your next dose is less than 12 hours away, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of Lanoxin can be fatal.

Overdose symptoms may include severe forms of some of the side effects listed in this medication guide.

What should I avoid while taking Lanoxin?

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Lanoxin overdose can occur more easily if you are dehydrated.

Lanoxin side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Lanoxin: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • fast, slow, or uneven heart rate;

  • bloody or black, tarry stools;

  • blurred vision, yellowed vision; or

  • confusion, hallucinations, unusual thoughts or behavior.

Less serious Lanoxin side effects may include:

  • nausea, vomiting, diarrhea, loss of appetite;

  • feeling weak or dizzy;

  • headache, anxiety, depression;

  • enlarged breasts in men; or

  • mild skin rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Lanoxin?

Many drugs can interact with Lanoxin. Below is just a partial list. Tell your doctor if you are using:

  • an antacid, or Kaopectate;

  • alprazolam (Xanax);

  • cancer medications;

  • clonidine (Catapres);

  • supplements or medications that contain calcium;

  • a diuretic (water pill), such as spironolactone (Aldactone, Aldactazide);

  • amphotericin B (Fungizone, AmBisome, Abelcet);

  • cholestyramine (Questran, Prevalite);

  • epinephrine (EpiPen);

  • indomethacin (Indocin);

  • isoproterenol (Isuprel);

  • itraconazole (Sporanox);

  • levothyroxine (Synthroid, Levothroid, and others);

  • metoclopramide (Reglan);

  • neomycin (Mycifradin, Neo-Fradin, Neo-Tab);

  • rifampin (Rifadin, Rifater, Rifamate);

  • St. John's wort;

  • sulfasalazine (Azulfidine); or

  • an antibiotic such as erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), clarithromycin (Biaxin), or tetracycline (Brodspec, Panmycin, Sumycin, Tetracap);

  • heart or blood pressure medicine such as amlodipine (Norvasc, Caduet, Exforge, Lotrel, Tekamlo, Tribenzor, Twynsta, Amturnide), carvedilol (Coreg), diltiazem (Cardizem, Cartia, Dilacor, Diltia, Diltzac, Taztia, Tiazac), metoprolol (Dutoprol, Lopressor, Toprol), nebivolol (Bystolic), nifedipine (Nifedical, Procardia), verapamil (Calan, Covera, Isoptin, Verelan, Tarka), and others;

  • decongestant cold or allergy medicine, or nasal sprays such as Afrin, Duramist, Neo-Synephrine, Tysine Nasal, and others;

  • a heart rhythm medication such as amiodarone (Cordarone, Pacerone), propafenone (Rythmol), or quinidine (Quin-G); or

  • steroids such as prednisone, fluticasone (Advair), mometasone (Asmanex, Nasonex), dexamethasone (Decadron, Hexadrol) and others.

This list is not complete and there are many other drugs that can interact with Lanoxin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

For the Consumer

Applies to digoxin: oral capsule liquid filled, oral elixir, oral solution, oral tablet

Along with its needed effects, digoxin (the active ingredient contained in Lanoxin) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking digoxin:

More common
  • Dizziness
  • fainting
  • fast, pounding, or irregular heartbeat or pulse
  • slow heartbeat
Rare
  • Black, tarry stools
  • bleeding gums
  • blood in the urine or stools
  • bloody vomit
  • pinpoint red spots on the skin
  • rash with flat lesions or small raised lesions on the skin
  • severe stomach pain
  • unusual bleeding or bruising
Incidence not known
  • Chest pain or discomfort
  • nausea
  • shortness of breath
  • sweating
  • swelling of the feet and lower legs
  • troubled breathing
  • unusual tiredness or weakness

Some side effects of digoxin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
  • Agitation or combativeness
  • anxiety
  • confusion
  • depression
  • diarrhea
  • expressed fear of impending death
  • hallucinations
  • rash
  • vomiting
Incidence not known
  • Blurred or loss of vision
  • disturbed color perception
  • double vision
  • halos around lights
  • headache
  • lack of feeling or emotion
  • loss of appetite
  • night blindness
  • overbright appearance of lights
  • swelling of the breasts or breast soreness in both females and males
  • tunnel vision
  • weakness
  • weight loss

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Applies to digoxin: compounding powder, injectable solution, oral capsule, oral elixir, oral tablet

General

Side effects generally have been dose-related and occurred more frequently when serum digoxin (the active ingredient contained in Lanoxin) levels exceed 2.0 ng/mL. Cardiovascular (50%), gastrointestinal (25%), and CNS symptoms (25%) have been reported most often.

Patients at increased risk include those with underlying renal, cardiopulmonary, or thyroid disease, electrolyte imbalances such as hypokalemia, hypomagnesemia, or hypercalcemia, and patients greater than 65 years of age.

Gastrointestinal

Gastrointestinal side effects reported in 25% of patients have included anorexia, nausea, vomiting, diarrhea, and general abdominal pain. Rarely, intestinal ischemia or hemorrhagic necrosis, dysphagia, and esophageal dystonia have been reported.

Cases of severe abdominal pain and documented intestinal ischemia have been reported in patients after hemodialysis. Contraction of intravascular volume combined with digoxin-induced splanchnic vasoconstriction may induce abdominal pain.

Cardiovascular

Cardiovascular side effects have been reported the most frequently. These have included premature ventricular depolarizations (50%), AV nodal arrhythmias (50%), AV conduction disturbances (36%), wide complex tachycardia (less than 1%), paroxysmal atrial tachycardia with AV block, complete heart block, PR prolongation, and ST segment changes.

Ocular

Ocular side effects have included chromatopsia, snowy or blurry vision, photopsia, and decreased visual acuity. Rarely, transient blindness has been reported. Decreased color vision has been reported.

The development of photopsia characterized by innumerable points of light in the peripheral visual fields or a decrease in visual acuity has been associated with therapeutic serum digitalis concentrations in the elderly. Digitalis-induced visual disturbances other than chromatopsia or disturbances of color vision may occur in elderly patients who have no other clinical manifestations of digitalis intoxication.

Digoxin-mediated inhibition of sodium-potassium ATPase influences normal uptake of extracellular potassium by Muller's cells and other retinal neurons and may result in decreased color vision.

Nervous system

Nervous system side effects reported in 25% of patients have included headache, dizziness, and weakness. At least one case of trigeminal neuralgia has been reported.

A 51-year-old man with ischemic cardiomyopathy complicated by congestive heart failure developed right trigeminal neuralgia associated with hyperalgesia between attacks. The pain resolved when digoxin was discontinued and reappeared upon rechallenge.

Psychiatric

Psychiatric side effects have included decreased cognition, memory, disorientation, emotional lability, and depression.

A 74-year-old man with supraventricular tachycardia developed altered cognition, memory, and depression with a serum digoxin level of 0.9 ng/mL. Symptoms resolved when digoxin levels decreased to 0.5 ng/mL.

Endocrine

Endocrine side effects have included increased (significant) serum estrogen, decreased serum luteinizing hormone, decreased (significant) serum testosterone, and gynecomastia.

A study of 38 patients (20 postmenopausal women) who had taken digoxin for at least two years, revealed significantly decreased serum luteinizing hormone and testosterone levels and significantly increased serum estrogen levels relative to a control group of men and postmenopausal women. The study did not control for underlying disease and it is possible that the sex hormone alterations were associated with the underlying diseases rather than use of digoxin.

Hypersensitivity

A 77-year-old man with congestive heart failure developed a psoriasiform rash associated with a positive macrophage inhibition factor test to digoxin (the active ingredient contained in Lanoxin) The rash resolved upon discontinuation of the drug and reappeared on rechallenge.

Hypersensitivity reactions have been reported rarely. At least one case of psoriasiform rash has been reported.

Hematologic

Hematologic side effects have been reported rarely. These have included thrombocytopenia.

A 60-year-old man with thyroid cancer and supraventricular tachycardia developed reversible thrombocytopenia during digoxin and heparin therapy. The thrombocytopenia resolved when digoxin alone was discontinued. The bone marrow examination and immunological studies were consistent with a digoxin-induced immune thrombocytopenia due to circulating immune complexes.

Metabolic

Three patients with Type II diabetes who experienced greater antidiabetic control and significant reduction in requirements of hypoglycemic agents following discontinuation of digoxin (the active ingredient contained in Lanoxin) has been reported. Rechallenge in one patient resulted in increased glucose levels and subsequent dosage increases of hypoglycemic agents.

Metabolic side effects have included hypokalemia, hypomagnesemia, and hypercalcemia. Diabetes mellitus and glucose intolerance have been reported.

Dermatologic

Dermatologic side effects have been reported rarely. These have included maculopapular rash and other nonspecific skin reactions.

Other

Other side effects have been reported rarely. At least one case of diaphoresis and malaise has been reported. At least one case of digoxin (the active ingredient contained in Lanoxin) cachexia, fatigue, weight loss, and decreased appetite has been reported.

A 48-year-old man with rheumatic mitral valve disease and atrial flutter/fibrillation developed profound diaphoresis and malaise associated with a serum digoxin level of 0.7 ng/mL. The symptoms resolved when digoxin was discontinued, and reappeared on rechallenge.

Cachexia, fatigue, and documented weight loss have been reported in rare cases. Appetites and weights improved after discontinuation of digoxin.