CV: bradycardia, ECG changes, ARRHYTHMIAS, heart block.
EENT: blurred vision, yellow or green vision.
GI: anorexia, nausea, vomiting, diarrhea.
Hemat: thrombocytopenia.
Neuro: fatigue, headache, weakness.
For rapid effect, a larger initial loading dose should be given in several divided doses over 1224 hr. Maintenance doses are determined for digoxin by renal function. All dosing must be evaluated by individual response. In general, doses required for atrial arrhythmias are higher than those for inotropic effect.
- IV, IM (Adults): Loading dose: 0.51 mg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals.
- IV, IM (Children >10 yr): Loading dose: 812 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals.
- IV, IM (Children 510 yr): Loading dose: 1530 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals.
- IV, IM (Children 25 yr): Loading dose: 2535 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals.
- IV, IM (Children 124 mo): Loading dose: 3050 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals.
- IV, IM (Infants full term): Loading dose: 2030 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals.
- IV, IM (Infants premature): Loading dose: 1525 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals.
- PO (Adults): Loading dose: 0.751.5 mg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals. Maintenance dose: 0.1250.5 mg/day depending on patients lean body weight, renal function, and serum level.
- PO (Geriatric Patients): Initial daily dose should not exceed 0.125 mg.
- PO (Children >10 yr): Loading dose: 1015 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals. Maintenance dose: 2.55 mcg/kg given daily as a single dose.
- PO (Children 510 yr): Loading dose: 2035 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals. Maintenance dose: 510 mcg/kg given daily in 2 divided doses.
- PO (Children 25 yr): Loading dose: 3040 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals. Maintenance dose: 7.510 mcg/kg given daily in 2 divided doses.
- PO (Children 124 mo): Loading dose: 3560 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals. Maintenance dose: 1015 mcg/kg given daily in 2 divided doses.
- PO (Infants full term): Loading dose: 2535 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals. Maintenance dose: 610 mcg/kg given daily in 2 divided doses.
- PO (Infants premature): Loading dose: 2030 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals. Maintenance dose: 57.5 mcg/kg given daily in 2 divided doses.
Therapeutic Classification: antiarrhythmics, inotropics
Pharmacologic Classification: digitalis glycosides
Absorption: 6080% absorbed after oral administration of tablets; 7085% absorbed after administration of elixir; 80% absorbed from IM sites (IM route not recommended due to pain/irritation). IV administration results in complete bioavailability.
Distribution: Widely distributed to tissues.
Metabolism/Excretion: Excreted almost entirely unchanged by the kidneys.
Half-life: 3648 hr (↑ in renal impairment).
(antiarrhythmic or inotropic effects, provided that a loading dose has been given)
Duration listed is that for normal renal function; in impaired renal function, duration will be longer.