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The following safety information outlines crucial warnings associated with the use of Digoxin (Lanoxin). It is important to thoroughly review these details and discuss any concerns with your healthcare provider.

• Abnormal Heart Rhythm: Digoxin may lead to irregular heart rhythms, which can be serious or life-threatening, particularly in individuals with a history of heart rhythm disorders. It is essential to inform your healthcare provider of your complete medical history before starting this medication. If you are undergoing electrical treatment for atrial fibrillation, you might need to pause taking Digoxin 1 or 2 days prior. Seek immediate medical help if you experience symptoms such as chest pain, palpitations, shortness of breath, or sweating. This risk is heightened in individuals with Wolff-Parkinson-White syndrome, a history of heart rhythm issues, or those taking other medications affecting heart rate.

• Digoxin Toxicity: Excessive levels of Digoxin in the body can lead to toxicity. Regular monitoring of kidney function and Digoxin blood levels is necessary to ensure appropriate dosing. Be alert for signs like nausea, vomiting, appetite loss, vision changes, confusion, palpitations, or a slow heart rate, and seek medical attention if they occur. Factors increasing toxicity risk include low body weight, advanced age, kidney issues, abnormal potassium, magnesium, or calcium levels, and interactions with other medications.

• Worsening Heart Conditions: Digoxin may exacerbate symptoms in certain heart conditions. It's crucial to disclose all health issues to your provider to determine if Digoxin is suitable for you. This is particularly important if you have a history of heart conditions such as heart attack, myocarditis, cardiomyopathy, pericarditis, or amyloid heart disease.

• Reduced Efficacy with Low Calcium Levels: The effectiveness of Digoxin may decrease if your calcium levels are low. Your provider might recommend calcium supplements to optimize Digoxin's benefits.

• Special Considerations for Thyroid and Metabolism Issues: Individuals with an underactive thyroid may require a lower dose of Digoxin. Conversely, those with atrial fibrillation due to an overactive thyroid or metabolism may not respond well to Digoxin, necessitating treatment of the underlying condition.

Contraindications:

• Digoxin should not be used in individuals with ventricular fibrillation, a severe form of abnormal heart rhythm. If this applies to you, consult your healthcare provider before starting this medication.

Common side effects:

• Changes in heart rate
• Nausea
• Vomiting
• Diarrhea
• Reduced appetite

Less common but important to monitor:

• Headaches
• Weakness
• Dizziness
• Confusion
• Skin rashes
• Enlarged male breasts

Serious side effects:

• Abnormal heart rhythm
• Chest pain
• Discomfort
• Palpitations
• Shortness of breath
• Fatigue
• Sweating
• Digoxin toxicity
• Visual changes
• Abnormally slow heart rate

Digoxin is a medication used to treat certain heart conditions, but it can interact with various other drugs, potentially leading to serious side effects. Understanding these interactions is crucial for safe and effective treatment.

Medications That Increase Digoxin Levels:

Some drugs can raise the amount of digoxin in your body, increasing the risk of toxicity. These include certain antibiotics like Azithromycin, Clarithromycin, and Erythromycin; antifungal medications such as Itraconazole and Ketoconazole; and heart medications like Amiodarone, Verapamil, and diltiazem. When taken together, your doctor may need to adjust your digoxin dose and monitor your levels closely.

Medications That Decrease Digoxin Levels:

Other substances can lower digoxin levels, reducing its effectiveness. St. John's wort, a common herbal supplement, is known to decrease digoxin levels. If you're using such supplements, inform your healthcare provider to ensure proper management.

Medications That Affect Electrolyte Balance:

Diuretics, often used to manage blood pressure or fluid retention, can alter electrolyte levels in your body, particularly potassium. Low potassium levels can heighten the effects of digoxin, increasing the risk of side effects. Regular monitoring of electrolyte levels is important when using these medications together.

Other Notable Interactions:

Certain medications, including beta-blockers like Atenolol and metoprolol, can slow your heart rate. When combined with digoxin, this effect may be amplified, leading to bradycardia (a slower than normal heart rate). Additionally, calcium channel blockers such as verapamil and diltiazem can increase digoxin levels and enhance its effects on heart conduction, necessitating careful monitoring.

Herbal and Dietary Considerations:

Herbal supplements like licorice and Siberian ginseng may interact with digoxin, potentially leading to increased effects or toxicity. High-fiber foods can also affect digoxin absorption. It's advisable to discuss any herbal products or significant dietary changes with your healthcare provider.

Given digoxin's narrow therapeutic range, even minor changes in its levels can have significant effects. Always inform your healthcare provider about all medications, supplements, and dietary habits to ensure safe and effective use of digoxin.