Skip to Main Content
Skip Nav Destination


Digoxin

Basics

Name

Digoxin

Pronunciation

(di JOKS in)

Brand Names: US

  • Digitek [DSC]
  • Digox [DSC]
  • Lanoxin
  • Lanoxin Pediatric

Therapeutic Category

  • Antiarrhythmic Agent, Miscellaneous
  • Cardiac Glycoside

Medication Safety Issues

Sound-alike/look-alike issues:

Digoxin may be confused with Desoxyn, doxepin

Lanoxin may be confused with Lasix, levothyroxine, Levoxyl, Levsinex, Lomotil, Mefoxin, naloxone, Xanax

High alert medication:

The Institute for Safe Medication Practices (ISMP) includes this medication (IV and oral formulations) and also drug class (antiarrhythmics, IV; inotropic medications, IV) among its list of drugs/classes which have a heightened risk of causing significant patient harm when used in error (High-Alert Medications in Acute Care and Long-Term Care Settings).

Older Adult: High-Risk Medication:

Beers Criteria: Digoxin is identified in the Beers Criteria as a potentially inappropriate medication to be avoided in patients 65 years and older as first-line therapy for atrial fibrillation (due to safer and more effective alternatives for rate control) or as first-line therapy for heart failure (due to conflicting and low quality evidence for benefits and harms, evidence that other agents decrease hospitalizations and mortality, and lack of additional benefit when higher doses are used despite the increased risk of toxicity). Exercise caution when discontinuing therapy in patients with heart failure with reduced ejection fraction due to limited evidence suggesting worse outcomes following discontinuation. If used, avoid doses greater than 0.125 mg/day due to decreased renal clearance of digoxin which may result in increased risk of toxic effects; further dose reductions may be warranted in patients with Stage 4 or 5 chronic kidney disease (Beers Criteria [AGS 2023]).

Digoxin is identified in the Screening Tool of Older Person's Prescriptions (STOPP) criteria as a potentially inappropriate medication in older adults (≥65 years of age) as first-line therapy for long-term (>3 months) treatment in atrial fibrillation. In addition, some disease states of concern include renal impairment, heart failure, bradycardia, heart block, or history of QTc prolongation (O’Mahony 2023).

International issues:

Lanoxin [US, Canada, and multiple international markets] may be confused with Limoxin brand name for ambroxol [Indonesia] and amoxicillin [Mexico]

This item requires a subscription. For full access to this content, please log in to an existing user account or purchase an individual subscription. If you have an active subscription and appear logged in (your name appears in the upper right corner), but you cannot access content, please click the “Log Out” option under your name and log back in.
Close Modal

or Create an Account

Close Modal
Close Modal