Buy Generic Digoxin Online

Generic Digoxin Information

Introduction

Digoxin is a cardiac glycoside used primarily to improve heart contractility and to control ventricular rate in atrial fibrillation. It belongs to the cardiovascular medication group and is listed on the Hong Kong Department of Health’s Drug Formulary for adult patients with heart failure or certain arrhythmias. While the drug was originally developed for its inotropic properties, clinicians also employ it for symptomatic relief in chronic heart failure and for rate control when β‑blockers or calcium‑channel blockers are insufficient.

What is Digoxin?

Digoxin is the generic version of Lanoxin®, the well‑known brand introduced by Eli Lilly in the 195s. Both contain the same active compound, digoxin, a naturally derived cardiac glycoside extracted from Digitalis lanata. The medication is classified as a cardiac glycoside and is manufactured by multiple licensed pharmaceutical companies worldwide, including generic producers that supply the Hong Kong market.

Digoxin is the generic version of Lanoxin®, containing the same active compound Digoxin. Our online pharmacy provides this generic alternative as a cost‑effective treatment option.

How Digoxin Works

Digoxin binds to the Na⁺/K⁺‑ATPase pump on cardiac myocyte membranes. This inhibition increases intracellular sodium, which indirectly raises intracellular calcium via the Na⁺/Ca²⁺ exchanger. Higher calcium availability enhances the force of myocardial contraction (positive inotropy).

In the atrioventricular (AV) node, digoxin shortens the refractory period and slows conduction, producing a vagomimetic effect that reduces ventricular rate during atrial fibrillation. The onset of therapeutic effect typically appears within 2–4 hours after oral dosing, with a peak concentration at 1–3 hours. The elimination half‑life averages 36 hours in patients with normal renal function, but it can extend to 2 weeks in severe renal impairment, necessitating dose adjustment.

Conditions Treated with Digoxin

• Chronic Heart Failure (CHF) with reduced ejection fraction – improves symptoms, exercise tolerance, and hospitalisation rates when used in conjunction with guideline‑directed therapy.
• Atrial Fibrillation (AF) with rapid ventricular response – provides rate control, especially in sedentary patients or when β‑blockers are contraindicated.
• Atrial Flutter – similar rate‑controlling effect as in AF.

In Hong Kong, heart failure prevalence is estimated at 1–2 % of adults, and AF affects roughly 1.5 % of the population, rising sharply with age. Digoxin remains a valued adjunct because of its oral administration, inexpensive cost, and established safety profile when monitored correctly.

Patient Groups Most Likely to Benefit

• Elderly patients (≥ 65 years) with chronic systolic heart failure who are already on ACE inhibitors, β‑blockers, and diuretics but still experience fatigue or dyspnoea.
• Patients with AF who cannot tolerate β‑blockers due to severe asthma, chronic obstructive pulmonary disease, or bradycardia.
• Individuals with preserved renal function (eGFR ≥ 60 mL/min/1.73 m²), as digoxin clearance is primarily renal.

Conversely, digoxin is generally avoided in:

• Severe renal impairment (eGFR < 30 mL/min/1.73 m²) without dose reduction.
• Patients with significant electrolyte disturbances, especially hypokalaemia or hypermagnesaemia, which predispose to toxicity.
• Pregnant or lactating women, unless benefits outweigh risks and specialist supervision is provided.

Risks, Side Effects, and Interactions

Common

• Nausea, vomiting, and loss of appetite – gastrointestinal upset occurs in up to 10 % of users.
• Fatigue or dizziness – related to slowed AV conduction.
• Blurred vision or colour disturbance (yellow‑green halos) – early sign of rising serum levels.

Rare

• Arrhythmias (e.g., premature ventricular complexes, atrial tachycardia) – may develop when serum digoxin exceeds the therapeutic window.
• Dermatologic reactions – rash or photosensitivity reported in isolated cases.

Serious

• Life‑threatening ventricular tachyarrhythmias – especially in the presence of electrolyte imbalance or renal failure.
• Heart block (2nd‑ or 3rd‑degree AV block) – requires immediate medical attention.
• Severe hyperkalaemia – paradoxically may occur with acute toxicity and mandates urgent treatment.

Clinically Relevant Drug–Drug Interactions

• Loop diuretics (e.g., furosemide) – cause hypokalaemia, heightening toxicity risk.
• Amiodarone, quinidine, verapamil – increase serum digoxin by inhibiting P‑glycoprotein transport and CYP3A4 metabolism, often necessitating a 30–50 % dose reduction.
• Antibiotics such as erythromycin or clarithromycin – raise digoxin concentrations via P‑glycoprotein inhibition.
• St. John’s wort – may lower digoxin levels by inducing P‑glycoprotein.

Patients should disclose all prescribed, over‑the‑counter, and herbal products before initiating digoxin.

Practical Use: Dosing, Missed Dose, Overdose

• Initial adult dose for heart failure: .125 mg (.05 mg for frail elders) once daily, adjusted after 6–8 weeks based on serum level (target .5–.9 ng/mL).
• AF rate control: .125 mg once daily; loading doses are rarely required in modern practice.
• Renal adjustment: Reduce dose by 50 % if eGFR < 30 mL/min/1.73 m²; monitor levels weekly until stable.

Missed dose: Take the missed tablet as soon as remembered only if more than 6 hours have not passed; otherwise skip and resume the regular schedule. Doubling up is unsafe.

Overdose management: Immediate medical evaluation is essential. Activated charcoal may be administered if ingestion is recent. Antidotal therapy with digoxin‑specific antibody fragments (Digibind®) is indicated for life‑threatening toxicity.

Precautions:

• Avoid high‑potassium diets or potassium‑saving diuretics without monitoring.
• Alcohol does not directly affect digoxin but can exacerbate hypotension; consume in moderation.
• Take the medication with or without food; steady timing each day improves serum stability.

Buying Digoxin from Our Online Pharmacy

Patients in Hong Kong can obtain digoxin safely through our online pharmacy.

• Affordable pricing: Our generic supply is sourced near manufacturer cost, offering a price advantage of up to 40 % compared with brand‑name tablets.
• Verified quality: Every batch is procured from licensed, GMP‑certified overseas manufacturers and undergoes independent laboratory testing.
• Guaranteed delivery: Discreet packaging is dispatched via express courier (delivery in ≤ 7 days) or regular airmail (≈ 3 weeks), with tracking available for all orders.
• Online‑only access: We specialise in medicines that may have limited local pharmacy stock, ensuring continuity of care for patients with chronic cardiac conditions.

Our service operates as a pharmacy broker, partnering with overseas licensed pharmacies. This model permits a discreet, privacy‑respecting process while maintaining compliance with Hong Kong regulations.

FAQ

• Is Digoxin available in both brand‑name and generic forms in Hong Kong?
  Yes. The original brand is Lanoxin®, while multiple generic manufacturers sell the same active compound under the name Digoxin. Generic versions are typically lower in cost and equally effective when sourced from reputable suppliers.

• What is the recommended storage condition for digoxin tablets?
  Digoxin should be stored at room temperature (15 °C–30 °C), away from direct sunlight, heat, and moisture. Keep the container tightly closed and out of reach of children.

• Can digoxin be imported for personal use without a Hong Kong prescription?
  Personal importation of prescription‑only medicines requires a valid prescription from a Hong Kong‑registered clinician. Our online pharmacy facilitates the professional evaluation step to ensure regulatory compliance.

• Do Asian populations have specific dosing recommendations for digoxin?
  Studies suggest that body weight and renal function, rather than ethnicity, drive dosing. However, clinicians in Hong Kong often start at the lower end of the dosing range (.125 mg) due to the higher prevalence of reduced renal clearance in older Asian patients.

• What packaging does digoxin arrive in when ordered online?
  Orders are shipped in tamper‑evident, sealed blister packs or bottles, each labelled with batch number, expiry date, and storage instructions.

• Are there differences between US and EU formulations of digoxin?
  Formulation differences are minimal; both regions use tablets containing .125 mg of digoxin. Variations may exist in excipients, which can affect tolerability in patients with specific allergies.

• Can digoxin be combined with telemedicine‑based treatment plans?
  Yes. Telemedicine consultations can provide the necessary clinical assessment and documentation for a valid prescription, after which our pharmacy completes the professional evaluation and delivers the medication.

• How frequently should serum digoxin levels be checked?
  Initial monitoring is performed 6–8 weeks after starting therapy, then every 3–6 months in stable patients. More frequent checks are required after dose adjustments, renal function changes, or when interacting drugs are added.

• What is the process for a professional evaluation before purchase?

• Is there a risk of digoxin toxicity with herbal supplements?
  Certain herbal products, such as St. John’s wort, can lower digoxin concentrations, while others like licorice may increase serum levels indirectly through electrolyte changes. Patients should inform their prescriber of any supplement use.

Glossary

Na⁺/K⁺‑ATPase

An enzyme that pumps sodium out of cells and potassium into cells, crucial for maintaining cellular electrical balance. Digoxin’s inhibition of this pump underlies its cardiac effects.

Therapeutic Window

The plasma concentration range in which a drug offers maximal benefit with minimal adverse effects. For digoxin, the window is typically .5–.9 ng/mL.

P‑glycoprotein (P‑gp)

A membrane transporter that pumps many drugs out of cells. Inhibition of P‑gp by certain medications (e.g., amiodarone) can raise digoxin levels.

AV Node

The atrioventricular node, a part of the heart’s electrical conduction system that regulates the passage of impulses from the atria to the ventricles. Digoxin slows conduction through this node, aiding rate control.

⚠️ Disclaimer

The information provided about Digoxin is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to 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.