Patient Medication Information: uses, side effects, how to take - Apo-Digoxin
ABOUT THIS MEDICATION
What the medication is used for:
This medicine is used for patients who have congestive heart failure. Heart failure, results when the heart cannot pump blood well enough to supply the body's needs. As a result, circulation becomes poor, and fluid can build up in the lungs and legs. This medicine can also be used in patients with fast heart rate or irregular heart rhythm. If you have a rapid or irregular heart beat, such as atrial fibrillation (sometimes called "a-fib"), digoxin can slow down and control your heart rate.
What it does:
If you have heart failure, digoxin can improve your heart's ability to pump blood. Better pumping of the heart will often improve symptoms such as shortness of breath. As a result, you may find it easier to go about your daily activities.
When it should not be used:
If you have ever had any unusual or allergic reaction to digoxin medicines or any of the nonmedicinal ingredients in the product (see What the nonmedicinal ingredients are).
What the medicinal ingredient is:
Digoxin
What the nonmedicinal ingredients are:
Lactose, magnesium stearate, starch (corn); and the following colouring agents: D&C yellow no. 10 aluminum lake 14-18% (0.125 mg), sunset yellow aluminum lake 40% (0.0625 mg) and yellow ferric oxide (0.125 mg)
What dosage forms it comes in:
0.0625 mg, 0.125 mg, and 0.25 mg tablets
WARNINGS AND PRECAUTIONS
Serious Warnings and Precautions
- Do not take other prescription, non-prescription and herbal medications without advice from your doctor.
Although digoxin has been prescribed to help some patients lose weight, it should never be used in this way. When used improperly, digoxin can cause serious problems.
BEFORE you use APO-DIGOXIN talk to your doctor or pharmacist if:
You are pregnant or could become pregnant during treatment. Digoxin crosses the placenta and should not be used in pregnant women unless absolutely needed;
- You are breast-feeding. Digoxin is distributed into breast milk; caution should be used
- You are taking any other prescription, non-prescription and herbal medication.
- You are over 65 years of age, you may be more likely to experience side effects from digoxin. You may require a dosage adjustment or special monitoring.
- You have ever had any unusual or allergic reaction to digitalis medicines
The presence of other medical problems may affect the use of digitalis medicines. Make sure you tell your doctor if you have any other medical problems, especially:
- Electrolyte disorders (Imbalance in bodily salts)
- Heart disease
- Lung disease (severe)
- Heart rhythm problems
- Kidney disease
- Liver disease
- Thyroid disease
INTERACTIONS WITH THIS MEDICATION
Drugs that may interact with APO-DIGOXIN include:
- another medication for irregular heartbeats, such as dronedarone, quinidine, amiodarone, or propafenone;
- an antacid or laxative that contains aluminum, magnesium, or kaolin-pectin such as Maalox, Rolaids, Mylanta, milk of magnesia, and others;
- an antidepressant called bupropion;
- a beta-blocker such as atenolol, propranolol, acebutolol, metoprolol, labetalol or nadolol;
- a calcium channel blocker such as diltiazem amlodipine, felodipine, nifedipine, verapamil and others;
- a cancer chemotherapy drug;
- a diuretic (water pill) such as hydrochlorothiazide, chlorothiazide, chlorthalidone, furosemide, triamterene, amiloride, spironolactone and others;
- a steroid medicine such as prednisone, methylprednisolone, prednisolone, dexamethasone, and others;
- a thyroid medication;
- amphotericin B;
- cholestyramine or colestipol;
- erythromycin or clarithromycin;
- indomethacin;
- itraconazole;
- metoclopramide (Reglan);
- rifampin;
- protease inhibitors such as saquinavir/ritonavir, cobicistat, simeprevir;
- sulfasalazine;
- tetracycline.
Herbal products that may interact with APO-DIGOXIN (e.g. St. John’s wort).
You may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.
Drugs other than those listed here may also interact with digoxin or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.
PROPER USE OF THIS MEDICATION
Usual dose:
- Take digoxin exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
- Take each dose with a full glass of water.
- Try to take digoxin at the same time every day.
- Ask your doctor to teach you how to monitor your heart rate and at what heart rate you should notify them before taking any more medication.
- Do not stop taking digoxin without talking to your doctor. Stopping suddenly could make your condition worse. Even if you feel better, you may need to keep taking this medication to help the heart work properly.
- Make sure you always have enough digoxin on hand for vacations and holidays.
- Your doctor may want to perform blood tests during treatment with digoxin to monitor the amount of medication in your body.
- This medicine has been tested in children. Dosages should be individualized as directed by your doctor.
- It may take several weeks to several months for digoxin to improve your heart function. Don't be surprised if your symptoms don't get better right away. Keep taking your digoxin as prescribed. Digoxin is used to treat heart conditions that last for a long time, so you may take digoxin the rest of your life. Call your doctor if you have any problems with the drug.
- Dosage reduction may be required in patients with renal function impairment.
Overdose:
- Seek emergency medical attention
- Symptoms of a digoxin overdose include nausea, vomiting, decreased appetite, diarrhea, confusion, seizures, hallucinations, light "halos" around objects, green or yellow vision, fatigue, irregular heartbeats, and abnormally fast or slow heartbeats.
| If you think you have taken too much APO-DIGOXIN, contact your healthcare professional, hospital emergency department or regional poison control centre immediately, even if there are no |
| symptoms. |
Missed Dose:
Take the missed dose up to 12 hours late. If more than 12 hours have passed, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication. Tell your doctor if you have missed 2 or more days of APO-DIGOXIN.
SIDE EFFECTS AND WHAT TO DO ABOUT THEM
If you experience any of the following side effects, talk to your doctor if you experience:
- ⋅ depression;
- ⋅ decreased sex drive; or
- ⋅ enlarged breasts in males.
| SERIOUS SIDE EFFECTS, HOW OFTEN THEY HAPPEN AND WHAT TO DO ABOUT THEM | ||||||
|---|---|---|---|---|---|---|
| Symptom / effect | Talk to your healthcare professional immediately | Stop taking drug and get immediate medical help | ||||
| Only if severe | In all cases | |||||
| √ √ √ √ √ √ √ √ √ √ | √ | ||||
This is not a complete list of side effects. For any unexpected effects while taking APO-DIGOXIN, contact your doctor or pharmacist.
HOW TO STORE IT
Store at 15°C to 30°C in a tightly closed container in a dry place and protect from light. Avoid exposure to excessive heat. Keep out of reach and sight of children.
Reporting Side Effects
You can report any suspected side effects associated with the use of health products to Health Canada by:
NOTE: Contact your health professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice. |
MORE INFORMATION
If you want more information about APO-DIGOXIN:
- Talk to your healthcare professional
- Find the full product monograph that is prepared for healthcare professionals and includes this Consumer Information by visiting the Health Canada website (https://health-products.canada.ca/dpd-bdpp/index-eng.jsp). Find the Consumer Information on the manufacturer’s website (http://www.apotex.ca/products), or by calling 1-800-667-4708.