DIGOXIN TABLETS 0.25 mg
“For use only of a Registered Medical Practitioner or Hospital or Laboratory”
Each tablet contain
Digoxin tablets B.P. 0.25 mg
The main property of digoxin is its ability to increase the force of myocardial contraction. The effects of digoxin in patients with heart failure – increased cardiac output, decreased heart size, venous pressure, and blood volume; diuresis and relief of edema – are due to increased contractile force, a positive inotropic action. The second important action of digoxin is to slow the ventricular rate in atrial fibrillation or flutter.
Digoxin tablets may be used for initial digitalisation or maintenance therapy whenever digitalis therapy is indicated, such as the treatment of auricular fibrillation and congestive heart failure.
Digoxin is contra-indicated in patients with ventricular fibrillation and hypertrophic obstructive cardiomyopathy unless there is severe cardiac failure. Digoxin is also in patients with the Wolff-Parkinson-White syndrome, especially if it is accompanied, by atriaI fibrillation, since digoxin may precipitate ventricular tachycardia or
Injections of calcium salts should not be given during digoxin therapy.
Keep out of reach of children
DOSAGE AND DIRECTIONS FOR USE
The initial dose for rapid digitalisation is 2 to 3 tablets thereafter 1 – 2 tablets every six hours till the ventricular rate has dropped to normal. A total dose of 4 to 6 tablets given over 24 hours is normally adequate. A suitable maintenance dose should then be ascertained, which s 1 tablet once or twice daily. If a patient was digitilised in the preceding 10 to 14 days the initial dose should be reduced accordingly.
SIDE-EFFECTS AND SPECIAL PRECAUTIONS
Digoxin commonly produces side effects because the margin between the therapeutic and toxic doses is small.
Nausea, vomiting, and anorexia may be among the earliest symptoms of large doses of digoxin.
The most serious adverse effects are those on the heart. Toxic doses may cause or aggravate heart failure. Atrial or ventricular arrhythmias and defects of conduction are common and may be early indication of excessive dosage. In general the incidence and severity of arrhythmias is related to the severity of the underlying heart disease. Almost any arrhythmia may ensue, but particular note should be made of atrial tachycardia, especially atrioventricular (AV) junctional tachycardia and atrial tachycardia with block. Ventricular arrythmias including extrasytoles, sinoatrial block, sinus bradycardia, and AV block may also occur. Chronic digoxin toxicity is associated with hypokalaemia and adverse reactions to digoxin may be precipitated if there is potassium depletion such as may be caused by the prolonged administration of diuretics.
Digoxin should be used with caution in heart block, acute myocarditis such as rheumatic carditis and in patients with advanced heart failure and severe pulmonary disease.
Should be given with caution to patients who have received cardiac glycosides before. Early signs of digoxin toxicity should be watched for and the heart-rate should generally be maintained above 60 beats/minute.
Drugs which cause electrolyte disturbances increase the risk of toxicity from digoxin. Thiazides and loop diuretics cause potassium depIetion and also hypomagnesaemia which may lead to cardiac arrhythmias orticosteroids, carbenoxolone and amphotericin cause hypokalaemia. HypercaIcaemia may also incsease toxicity, and IV aadministration of calcium salts is best avoided during digoxin therapy. Digoxin should be given cautiously to patients receiving parathyroid extract or large doses of Vitamin D. Quinidine reduces renal excretion and thus plasma-digoxin levels may be doubled.
Blister 10 x 10 Tablets
1 x 1000 tablets in Plastic container.
1 x 5 x 10 Tablets
Manufactured in India for
NEM LABORATORIES PVT. LTD.
133, Krishna Ind. Estate, Vasai (E),
Thane 401 210, Maharashtra-India
Great Timec Pharma Co. Ltd.
Block no. 19 B, Niger Bridge,
Head Housing Estate, Onitsha, Nigeria.