Lanoxin Indication:

For the treatment and management of congestive cardiac insufficiency, arrhythmias and heart failure.

Lanoxin Mechanism Of Action:

Lanoxin inhibits the Na-K-ATPase membrane pump, resulting in an increase in intracellular sodium and calcium concentrations. Increased intracellular concentrations of calcium may promote activation of contractile proteins (e.g., actin, myosin). Lanoxin also acts on the electrical activity of the heart, increasing the slope of phase 4 depolarization, shortening the action potential duration, and decreasing the maximal diastolic potential.

Lanoxin Drug Interactions:

Acarbose Acarbose decreases the effect of digoxin
Alprazolam The benzodiazepine increases the effect of digoxin
Amiodarone Amiodarone increases the effect of digoxin
Bendroflumethiazide Possible electrolyte variations and arrhythmias
Benzthiazide Possible electrolyte variations and arrhythmias
Bleomycin The antineoplasic agent decreases the effect of digoxin
Bumetanide Possible electrolyte variations and arrhythmias
Carmustine The antineoplasic agent decreases the effect of digoxin
Carvedilol Carvedilol increases levels/effect of digoxin
Chlorothiazide Possible electrolyte variations and arrhythmias
Chlorthalidone Possible electrolyte variations and arrhythmias
Cholestyramine The resin decreases the effect of digoxin
Clarithromycin The macrolide increases the effect of digoxin in 10% of patients
Colestipol The resin decreases the effect of digoxin
Cyclophosphamide The antineoplasic agent decreases the effect of digoxin
Cyclosporine Cyclosporine increases the effect of digoxin
Cyclothiazide Possible electrolyte variations and arrhythmias
Cytarabine The antineoplasic agent decreases the effect of digoxin
Demeclocycline The tetracycline increases the effect of digoxin in 10% of patients
Dextrothyroxine The thyroid hormone decreases the effect of digoxin
Diazepam The benzodiazepine increases the effect of digoxin
Dihydroquinidine barbiturate Quinine/quinidine increases the effect of digoxin
Doxorubicin The antineoplasic agent decreases the effect of digoxin
Doxycycline The tetracycline increases the effect of digoxin in 10% of patients
Erythromycin The macrolide increases the effect of digoxin in 10% of patients
Ethacrynic acid Possible electrolyte variations and arrhythmias
Furosemide Possible electrolyte variations and arrhythmias
Gatifloxacin Gatifloxacin increases the effect of digoxin
Ginseng Changes in digoxin serum levels
Hydrochlorothiazide Possible electrolyte variations and arrhythmias
Hydroflumethiazide Possible electrolyte variations and arrhythmias
Itraconazole Itraconazole increases the effect of digoxin
Indapamide Possible electrolyte variations and arrhythmias
Josamycin The macrolide increases the efect of digoxin in 10% of patients
Levothyroxine The thyroid hormones decreases the effect of digoxin
Liothyronine The thyroid hormones decreases the effect of digoxin
Methacycline The tetracycline increases the effect of digoxin in 10% of patients
Methimazole The antithyroid agent increases the effect of digoxin
Methyclothiazide Possible electrolyte variations and arrhythmias
Metolazone Possible electrolyte variations and arrhythmias
Minocycline The tetracycline increases the effect of digoxin in 10% of patients
Oxytetracycline The tetracycline increases the effect of digoxin in 10% of patients
Penicillamine Penicillamine decreases the effect of digoxin
Polythiazide Possible electrolyte variations and arrhythmias
Prazosin Prazosin increases the effect of digoxin
Procarbazine The antineoplasic agent decreases the effect of digoxin
Propafenone Propafenone increases the effect of digoxin
Propylthiouracil The antithyroid agent increases the effect of digoxin
Quinethazone Possible electrolyte variations and arrhythmias
Quinidine Quinine/quinidine increases the effect of digoxin
Quinidine barbiturate Quinine/quinidine increases the effect of digoxin
Rabeprazole Rabeprazole increases the effect of digoxin
Ranolazine Ranolazine increases digoxin's levels
Ritonavir Ritonavir increases levels/effect of digoxin
Rolitetracycline The tetracycline increases the effect of digoxin in 10% of patients
Spironolactone Increased digoxin levels and decreased effect in presence of spironolactone
St. John's Wort St. John's Wort decreases the effect of digoxin
Sulfasalazine Sulfasalazine decreases the effect of digoxin
Telithromycin Telithromycin may increase levels of digoxin
Telmisartan Telmisartan increases the effect of digoxin
Tetracycline The tetracycline increases the effect of digoxin in 10% of patients
Tolbutamide Tolbutamide increases the effect of digoxin
Trichlormethiazide Possible electrolyte variations and arrhythmias
Verapamil Verapamil increases the effect of digoxin
Vincristine The antineoplasic agent decreases the effect of digoxin
Methotrexate The antineoplasic agent decreases the effect of digoxin
Hydroxychloroquine Hydroxychloroquine increases the effect of digoxin
Liotrix The thyroid hormone decreases the effect of digoxin
Thyroglobulin The thyroid hormone decreases the effect of digoxin
Quinine Quinine/quinidine increases the effect of digoxin

Lanoxin Food Interactions:

Avoid bran and high fiber foods within 2 hours of taking this medication.
Avoid excess salt/sodium unless otherwise instructed by your physician.
Avoid salt substitutes containing potassium.
Avoid milk, calcium containing dairy products, iron, antacids, or aluminum salts 2 hours before or 6 hours after using antacids while on this medication.
Limit garlic, ginger, gingko, and horse chestnut.
Avoid avocado.

Lanoxin Generic Name:

Synonyms:

  • Digitalis Glycoside

Drug Type:

Small Molecule; Approved

Absorption:

Absorption of digoxin from the elixir pediatric formulation has been demonstrated to be 70% to 85% complete (90% to 100% from the capsules, and 60% to 80% for tablets).

Toxicity (Overdose):

Toxicity includes ventricular tachycardia or ventricular fibrillation, or progressive bradyarrhythmias, or heart block. LD50 = 7.8 mg/kg (orally in mice).

Protein Binding:

25%

Biotransformation:

Hepatic (but not dependent upon the cytochrome P-450 system). The end metabolites, which include 3 b-digoxigenin, 3-keto-digoxigenin, and their glucuronide and sulfate conjugates, are polar in nature and are postulated to be formed via hydrolysis, oxidation, and conjugation.

Half Life:

3.5 to 5 days

Dosage Forms of Lanoxin:

Liquid Intravenous
Powder, for solution Intravenous
Tablet Oral
Solution Oral

Chemical IUPAC Name:

4-[(3S,5R,8R,9S,10S,12R,13S,14S)-3-[(2R,4S,5S,6R)-5-[(2S,4S,5S,6R)-5-[(2S,4S,5S,6R)-4,5-dihydroxy-6-methyloxan-2-yl]oxy-4-hydroxy-6-methyloxan-2-yl]oxy-4-hydroxy-6-methyloxan-2-yl]oxy-12,14-dihydroxy-10,13-dimethyl-1,2,3,4,5,6,7,8,9,11,12,15,16,17-tetradecahydrocyclopenta[a]phenanthren-17-yl]-5H-furan-2-one

Organisms Affected:

Humans and other mammals

Lanoxin to general, pharmacology

General, pharmacology..
Cardiovascular