Therapeutic Action
Cardiotonic
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Drug reference
Cardiotonic
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Supraventricular arrhythmias (fibrillation, flutter, paroxysmal tachycardia) Heart failure
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Do not administer to patients with bradycardia, ill defined arrhythmia, coronary artery disease. It is essential to monitor heart rate in the initial stage of treatment. Narrow margin between therapeutic and toxic dose. May cause in the event of overdose: gastrointestinal disturbances (nausea, vomiting, diarrhoea), blurred vision, headache, confusion, conduction and rhythm disorders. If so, reduce dose or stop treatment. Do not combine with calcium, particularly by IV injection (serious arrhythmias). Monitor combination with: amiodarone, macrolides, itraconazole, quinine, chloroquine (increased digoxin concentration); potassium-depleting drugs: diuretics, corticoids, amphotericin B (increased risk of digoxin toxicity). Monitor if possible serum potassium level in patients taking potassium-depleting drugs and serum creatinine level in patients with renal impairment. Pregnancy: no contra-indication Breast-feeding: no contra-indication
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500 micrograms ampoule (250 micrograms/ml, 2 ml) for slow IV injection or infusion in 5% glucose or 0.9% sodium chloride
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Adult: Loading dose: 500 to 1000 micrograms The loading dose can be administered either by intravenous infusion as a single dose given over 2 hours minimum or in divided doses, by slow IV injections over 5 minutes minimum. Maintenance dose: change to oral treatment Reduce the dose by one half in older patients and in patients with renal impairment.
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A loading dose may be administered in arrhythmias if a rapid digitalisation is required. It is usually not required for heart failure.
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– Below 25 °C
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