Toloxin (Digoxin)

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.

In case of accidental drug overdose, contact a health care practitioner, hospital emergency department, or regional poison 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 TOLOXIN.

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 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 TOLOXIN, 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

Drugs that may interact with TOLOXIN include:

• another medication for irregular heartbeats, such as 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;
• 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;
• sulfasalazine or
• tetracycline

Herbal products that may interact with TOLOXIN (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.