Digoxin Medications

Digoxin is a cardiac glycoside that has been used for decades to improve the contractility of the failing heart and to control ventricular response in atrial fibrillation. It belongs to the class of Na⁺/K⁺-ATPase inhibitors, acting directly on myocardial cells to increase intracellular calcium and thereby strengthen each heartbeat. Commercially, digoxin is marketed under names such as Lanoxin, Digitek, and Digoxin-M, yet generic tablets are widely available through our online pharmacy. While its primary indications remain heart failure and atrial fibrillation, clinicians occasionally consider digoxin for certain supraventricular tachyarrhythmias, though such uses are not formally approved. Understanding how digoxin works, its dosing nuances, and its safety profile is essential for anyone contemplating buy digoxin online.

What is Digoxin?

Digoxin is a naturally derived cardiac glycoside extracted from the foxglove plant (Digitalis lanata). It is classified pharmacologically as a cardiac glycoside and is listed under the Health Sciences Authority (HSA) of Singapore as a prescription-only medicine. The U.S. Food and Drug Administration (FDA) first approved digoxin in 1961 for heart failure, and the European Medicines Agency (EMA) subsequently endorsed its use for atrial fibrillation with rapid ventricular response. The drug’s core mechanism involves reversible inhibition of the Na⁺/K⁺-ATPase pump on cardiac myocytes, leading to increased intracellular sodium, reduced calcium extrusion via the Na⁺/Ca²⁺ exchanger, and ultimately greater calcium availability for stronger contractions. Brand-name products such as Lanoxin, Digitek, and Digoxin-M coexist with inexpensive generic tablets that our pharmacy service can deliver directly to your door.

How Digoxin Works

Mechanism of Action

Digoxin binds with high affinity to the extracellular domain of the Na⁺/K⁺-ATPase enzyme in cardiac cells. By blocking this pump, the intracellular sodium concentration rises, which in turn diminishes the activity of the Na⁺/Ca²⁺ exchanger. The net effect is an accumulation of calcium within the sarcoplasmic reticulum, ready to be released during each action potential. This biochemical cascade heightens myocardial contractility (positive inotropy) and also exerts a vagomimetic effect on the sinoatrial and atrioventricular nodes, slowing conduction and reducing heart rate.

Therapeutic Effects

The enhanced contractility helps patients with systolic heart failure achieve better cardiac output, while the slowed AV nodal conduction stabilizes ventricular rates in atrial fibrillation. In addition, digoxin modestly lowers neurohormonal activation, a benefit reflected in long-term outcome studies.

Onset and Duration

After oral administration, peak plasma concentrations appear within 1-2 hours; clinical effects on heart rate may be noticeable within 4-6 hours. The drug’s half-life ranges from 36 to 48 hours in patients with normal renal function, allowing once-daily dosing for most indications. Renal impairment can extend the half-life beyond 72 hours, necessitating dose adjustments.

Approved Uses and Applications

Approved Indications

• Chronic heart failure (NYHA class II-IV) - improves symptoms, reduces hospitalizations, and modestly lowers mortality when used alongside guideline-directed therapy.
• Atrial fibrillation with rapid ventricular response - provides rate control when β-blockers or calcium-channel blockers are insufficient or contraindicated. Both indications are endorsed by the FDA, EMA, and HSA, with prescribing information emphasizing careful dose titration.

Off-Label Uses

Although not officially sanctioned, digoxin has been employed in:

• Paroxysmal supraventricular tachycardia (PSVT) when other agents fail.
• Digoxin immune Fab preparation to reverse acute toxicity. These applications are supported by case series and small trials, but clinicians must acknowledge that they lie outside formal regulatory approval.

Clinical Efficacy

A pivotal trial published in The New England Journal of Medicine demonstrated a 19 % reduction in combined mortality and hospitalization in heart-failure patients receiving digoxin versus placebo. In atrial fibrillation, the DIG trial reported a 23 % decrease in hospitalization for heart-failure decompensation when digoxin was added to rate-control therapy. These data underpin current guideline recommendations for digoxin’s role in selected patients.

Buying Digoxin from Our Online Pharmacy

Why Choose Our Service

Access to digoxin can be challenging in regions where supply is limited or insurance formularies restrict availability. Our pharmacy service bridges that gap, offering a discreet, secure channel to obtain authentic medication without leaving home.

Brand Names and Generic Options

• Lanoxin - well-known brand formulation, .125 mg tablets.
• Digitek - .25 mg tablets marketed in several Asian markets.
• Generic digoxin - identical active ingredient, typically 30 %-40 % cheaper than brand versions. All products are sourced from licensed manufacturers that meet WHO-Good Manufacturing Practice standards.

Quality & Safety

We partner with licensed international pharmacies that operate under strict regulatory oversight, ensuring each shipment complies with HSA safety requirements.

Pricing & Access

Our platform lists competitive prices, with additional savings on generic units. Lifetime 10 % discount on all reorders rewards repeat customers and helps manage long-term therapy costs.

Discreet Delivery

Orders ship via express (≈ 7 days) or standard (≈ 3 weeks) services, packed in unmarked, tamper-evident envelopes to protect privacy.

Dosing, Formulations & Administration

Available Formulations

• Oral tablets - .125 mg and .25 mg strengths.
• Oral solution - .05 mg/mL for patients requiring flexible dosing.
• Injectable - .5 mg/mL for acute inpatient use (not typically ordered online).

Typical Dosing Ranges

For adults with heart failure, clinicians often start with .125 mg once daily, adjusting after 1-2 weeks based on serum digoxin concentration and renal function. In atrial fibrillation, an initial dose of .25 mg once daily may be used, followed by maintenance dosing of .125 mg once daily if tolerable. Patients with creatinine clearance < 50 mL/min generally require a reduced dose (.125 mg every other day) to avoid accumulation.

Administration Guidelines

• Timing: Take the dose at the same time each day, preferably with or without food-digoxin’s absorption is not markedly affected by meals.
• Food Interactions: High-potassium foods (bananas, oranges) can mitigate toxicity, whereas low-potassium diets may increase risk.
• Special Considerations: Avoid crushing tablets for injection; the oral formulation must be swallowed whole.

The exact dose must be individualized by a qualified healthcare provider based on clinical status, renal function, and concurrent medications.

Safety Profile & Considerations

Common Side Effects

• Nausea or vomiting - reported in ~10 % of patients.
• Fatigue or weakness - seen in 8-12 % of users.
• Visual disturbances (yellow-green halos) - occur in ≤ 5 % of cases.
• Dizziness - affects about 4 % of treated individuals.

Serious Adverse Events

• Life-threatening arrhythmias (ventricular tachycardia, AV block) - rare but require immediate medical attention.
• Digoxin toxicity - manifested by nausea, vomiting, visual changes, and cardiac dysrhythmias; serum levels > 2 ng/mL generally signal toxicity.

Contraindications

• Second- or third-degree AV block without pacemaker.
• Ventricular fibrillation or ventricular tachycardia of uncertain origin.
• Severe hypersensitivity to digoxin or other cardiac glycosides.
• Acute myocardial infarction with unstable hemodynamics.

Drug Interactions

• CYP450 inhibitors (e.g., amiodarone, quinidine, verapamil) raise digoxin levels, often necessitating a 25-50 % dose reduction.
• Loop diuretics (furosemide) can cause hypokalemia, predisposing to toxicity.
• Macrolide antibiotics (clarithromycin, erythromycin) increase serum concentrations.
• St. John’s wort may lower levels, reducing efficacy.

Special Populations

• Pregnancy: Classified as Category C; animal studies show adverse effects, but human data are limited. Use only if benefit outweighs risk.
• Breastfeeding: Small amounts are excreted in milk; caution advised for newborns.
• Elderly: Age-related decline in renal function raises toxicity risk; start at the lowest possible dose.
• Renal or hepatic impairment: Dose adjustments are mandatory; monitor serum digoxin concentration closely.

Frequently Asked Questions

• How does digoxin differ from amiodarone for rate control? Digoxin reduces ventricular rate by enhancing vagal tone at the AV node, while amiodarone works primarily by blocking potassium channels and providing broader anti-arrhythmic effects. Digoxin’s effect is modest and may be insufficient in high-sympathetic states, whereas amiodarone offers more robust control but carries a heavier side-effect burden.

• How long does digoxin take to work for heart failure symptoms? Patients often notice improved exercise tolerance and reduced dyspnea within 1-2 weeks, although maximal benefit may require 4-6 weeks of stable dosing.

• What foods should I avoid while taking digoxin? Large amounts of high-potassium foods (e.g., bananas, oranges, potassium-rich salt substitutes) can lessen the drug’s efficacy, while low-potassium diets increase toxicity risk. Maintaining a balanced potassium intake is advisable.

• What are the early signs of digoxin toxicity? Nausea, vomiting, loss of appetite, visual disturbances (yellow-green halos), and dizziness often precede more serious arrhythmias. Prompt medical evaluation is essential if these symptoms appear.

• What dosage is typical for atrial fibrillation? Clinicians frequently initiate therapy with .25 mg once daily, then titrate to .125 mg once daily based on heart-rate response and serum levels.

• Is digoxin safe for long-term use? Long-term safety has been confirmed in large trials, but continuous monitoring of renal function, electrolytes, and serum digoxin concentration is required to minimize cumulative toxicity.

• Can I take digoxin with other heart medications? Yes, but caution is needed with drugs that affect potassium levels (e.g., diuretics) or those that inhibit digoxin metabolism (e.g., amiodarone). Always disclose all current medications to your prescriber.

• Does taking digoxin with food affect its absorption? Food has minimal impact on digoxin bioavailability, so the medication can be taken with or without meals according to personal convenience.

• What should I do if I miss a dose of digoxin? Take the missed dose as soon as you remember, unless it is close to the time of your next scheduled dose. In that case, skip the missed dose and continue with the regular schedule-do not double-dose.

• What information should I provide my doctor when discussing digoxin?

  • Complete list of current medications, including over-the-counter drugs and supplements.
  • Recent laboratory results, especially kidney function and serum electrolytes.
  • History of any heart rhythm disorders or previous episodes of arrhythmia.
  • Any known allergies or adverse reactions to cardiac medications.

Disclaimer

The information provided about digoxin is for general knowledge only. It does not replace professional medical consultation or the official prescribing information for medications containing this ingredient. All treatment decisions, including dosing, formulation selection, and monitoring, should be made under the supervision of a qualified healthcare provider who can assess individual medical history, current medications, and specific health needs. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to medications containing digoxin for individuals who may have limited availability through traditional pharmacies, prescription-based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication containing digoxin.

External Resources about Digoxin

• Digoxin | Formula, Properties & Application
• Digoxin - Wikipedia
• Cardiac Glycosides: Digoxin, Mechanism of Action, Dosage and …
• Digoxin (CAS 20830-75-5)
• Digoxin Overview - Active Ingredient - RxReasoner