Buy Lanoxin
Lanoxin

0.39
Helps the heart pump better and controls irregular heart rhythms like atrial fibrillation.


Ingredient
Availability
In Stock
Delivery
Airmail (14-21 days) | EMS trackable (5-9 days)
Product is shipped in a fully discreet envelope with no content disclosure, including all required documentation inside

Product Sheet

Alternative/Local Brand
Digoxin
Active Ingredient(s)
Digoxin
Primary Category
Heart Rhythm Management, Heart Failure Treatment
Therapeutic Class
Cardiac therapy, Cardiac glycosides
Pharmacological Class
Digitalis glycoside
Indications
Atrial fibrillation, Atrial flutter, Chronic heart failure
Contraindications
Ventricular tachycardia/fibrillation, Hypertrophic obstructive cardiomyopathy, Certain heart block conditions
Minor Side Effects
Dizziness, Mild nausea
Moderate Side Effects
Loss of appetite, Diarrhoea, Blurred or yellow vision, Rash
Serious Side Effects
Heart arrhythmias, Mental confusion, Gynaecomastia (long-term use), Severe vomiting (sign of toxicity)
Dosage Forms
Tablet, Oral solution, Injection
Administration Route
Oral
Mechanism of Action
It works by increasing the force of the heart's contraction and slowing down the electrical signals between the top and bottom of the heart. This makes the heartbeat more efficient and regular.
Prescription Status
Rx
Manufacturer
Aspen
Patient Summary
Helps the heart pump better and controls irregular heart rhythms like atrial fibrillation.
Onset Time
30 mins to 2 hours
Duration
36-48 hours
Storage Instructions
Store at room temperature in a dry place.
Drug Interactions
Amiodarone, Spironolactone, Verapamil, Certain antibiotics, Diuretics (due to potassium risk)
Age Restrictions
Suitable for all ages; doses are very precisely calculated.
Pregnancy Use
Can be used if clinically necessary under monitoring.
Alternative Drugs
Bisoprolol, Sotalol, Diltiazem

What is Lanoxin?

Lanoxin contains digoxin as its active component. Digoxin is a cardiac glycoside used to treat certain heart conditions. It is available as a generic medication and marketed under brand names such as Lanoxin. In Hong Kong, Lanoxin is a prescription-only product supplied in pill form, each tablet containing 0.25 mg of digoxin. The medication is regulated by the Hong Kong Department of Health and aligns with international standards for safety and efficacy.

How Lanoxin Works in the Body

  • Primary target: Digoxin inhibits the sodium-potassium-ATPase pump in cardiac myocytes.
  • Resulting effect: Inhibition leads to a rise in intracellular sodium, which indirectly increases calcium influx via the sodium-calcium exchanger. The extra calcium enhances the force of cardiac contraction (positive inotropic effect).
  • Electrical impact: Digoxin also stimulates the vagus nerve, slowing conduction through the atrioventricular (AV) node. This helps control ventricular rate in atrial fibrillation.
  • Onset and duration: Clinical effects typically appear within 1-2 hours after oral dosing, with a therapeutic window lasting about 24 hours.

These mechanisms make digoxin useful for improving heart-pump efficiency and for rate control in certain rhythm disorders.

Conditions Treated by Lanoxin

  • Chronic heart failure (particularly NYHA class II-III) when other therapies are insufficient.
  • Atrial fibrillation (or atrial flutter) for ventricular rate control, especially when beta-blockers or calcium-channel blockers are contraindicated or inadequate.

These indications are recognized by regulatory agencies in Hong Kong and reflected in the product label.

Off-Label and Investigational Uses

Evidence from peer-reviewed studies has explored digoxin for:

  • Supraventricular tachycardia in patients who cannot tolerate other rate-controlling agents.
  • Heart failure with preserved ejection fraction (HFpEF) in limited observational cohorts.

These uses are not approved by the Hong Kong regulatory authority. Off-label use requires medical supervision and individualized risk assessment.

Who Should Not Use Lanoxin?

Absolute Contraindications

  • Known hypersensitivity to digoxin or any excipients in the tablet.
  • Ventricular fibrillation or ventricular tachycardia not being treated by a defibrillator.
  • Atrial fibrillation with Wolff-Parkinson-White syndrome (risk of rapid conduction).

Relative Contraindications

  • Significant renal impairment (creatinine clearance < 30 mL/min) - dose may need reduction.
  • Electrolyte disturbances, especially hypokalemia, hypomagnesemia, or hypercalcemia.
  • Pregnant or breastfeeding women - digoxin crosses the placenta and is excreted in breast milk; risk-benefit assessment required.

Special Populations

  • Elderly: May have reduced renal clearance; monitoring is essential.
  • Pediatric: Digoxin dosing is weight-based; Lanoxin tablets are not formulated for children.

Safety Profile: Side Effects and Interactions

Common Side Effects

  • Nausea, vomiting, and loss of appetite.
  • Dizziness or fatigue.
  • Visual disturbances (e.g., yellow-green halos).

These effects are typically mild and may improve with dose adjustment.

Serious Adverse Events

  • Life-threatening arrhythmias (e.g., premature ventricular contractions, atrioventricular block).
  • Severe bradycardia or heart block requiring medical intervention.
  • Signs of digoxin toxicity such as confusion, severe nausea, or visual changes.

If any serious symptoms appear, seek immediate medical care.

Drug Interactions

  • Amiodarone, verapamil, quinidine, and spironolactone - increase digoxin serum levels; monitoring required.
  • Diuretics (especially loop diuretics) - can cause hypokalemia, heightening toxicity risk.
  • Macrolide antibiotics (e.g., erythromycin) - may raise digoxin concentrations.

Patients should disclose all medications, supplements, and herbal products to their healthcare provider.

Food and Lifestyle Interactions

  • High-fiber meals can modestly reduce digoxin absorption; taking the pill consistently with respect to meals helps maintain stable levels.
  • St. John’s wort may lower digoxin concentrations; avoid concurrent use without supervision.
  • No known interaction with alcohol, but excess intake can worsen heart failure symptoms.

How to Take Lanoxin

  • Standard dosing: One 0.25 mg tablet taken orally once daily, preferably in the evening with a glass of water.
  • Renal adjustment: For patients with moderate to severe renal impairment, clinicians may start at 0.125 mg daily and titrate cautiously.
  • Missed dose: If remembered within 12 hours, take the missed tablet; otherwise skip and continue with the next scheduled dose. Do not double the dose.
  • Overdose: Symptoms include nausea, vomiting, visual changes, and cardiac arrhythmias. Seek emergency care; activated charcoal may be considered, and digoxin-specific antibody fragments (digoxin immune Fab) are the antidote when indicated.
  • Discontinuation: Sudden withdrawal is not typical, but dose reduction may be advised in the context of improving cardiac function or adverse effects.

All dosing decisions must be individualized by a qualified healthcare professional.

Monitoring and Follow-Up

  • Serum digoxin concentration: Target therapeutic range typically 0.5-2.0 ng/mL, measured 6-8 hours after the third dose.
  • Renal function: Serum creatinine and estimated glomerular filtration rate (eGFR) at baseline and periodically.
  • Electrolytes: Potassium, magnesium, and calcium levels should be checked, especially when diuretics are used.
  • Electrocardiogram (ECG): Baseline ECG and follow-up to assess rhythm and conduction intervals.

Regular follow-up with a cardiologist or primary care provider is recommended to ensure safe and effective therapy.

Storage and Handling

  • Store at room temperature (20-25 °C) away from excess heat, moisture, and direct sunlight.
  • Keep tablets in the original container with the lid tightly closed.
  • Keep out of reach of children; use child-proof packaging when available.
  • Dispose of unused medication according to local pharmacy or waste-management guidelines.

Medication-Specific Glossary

Positive Inotrope
A drug that increases the force of heart muscle contraction, improving cardiac output.
AV Node
The atrioventricular node; a cluster of cells that conducts electrical impulses from the atria to the ventricles, regulating heart rate.
Serum Digoxin Concentration
The amount of digoxin measured in the blood, used to guide dosing and assess toxicity risk.

Medical Disclaimer

This article provides educational information about Lanoxin and is not a substitute for professional medical advice. Treatment decisions, including use for unapproved indications, must be made under the guidance of a qualified healthcare provider. The content is intended for informational purposes and does not constitute medical recommendations. Always consult a physician before starting, stopping, or changing any medication regimen.

Lanoxin FAQ

Can I take Lanoxin with over-the-counter supplements?

Some supplements, such as St. John’s wort, may reduce digoxin levels, while high-dose calcium or magnesium can increase toxicity risk. Discuss any supplement use with your healthcare provider to avoid unwanted interactions.

Is it safe to travel internationally with Lanoxin?

Yes, but keep the medication in its original labeled container, carry a copy of the prescription, and be aware of any import restrictions for prescription drugs in the destination country. Maintain dosing schedule across time zones by using an alarm.

What should I do if I experience visual halos while on Lanoxin?

Visual disturbances are a potential sign of digoxin toxicity. Contact your healthcare provider promptly for assessment and possible blood level testing.

Does food affect how Lanoxin is absorbed?

High-fiber meals may slightly lower digoxin absorption. Taking the pill at the same time each day, with or without a small amount of food, helps maintain consistent blood levels.

How does Lanoxin differ from other heart failure medications?

Lanoxin provides a positive inotropic effect and slows AV-node conduction, whereas many other heart failure drugs (e.g., ACE inhibitors, beta-blockers) primarily reduce workload and neurohormonal activation. Digoxin is often added when additional symptom control is needed.

Can Lanoxin cause low blood pressure?

Lanoxin mainly influences heart rate and contractility rather than vascular tone. While it may indirectly affect blood pressure through improved cardiac output, significant hypotension is uncommon.

Is there a risk of dependence on Lanoxin?

No physiological dependence develops, but abrupt discontinuation may lead to worsening heart failure or arrhythmia recurrence. Any changes in therapy should be guided by a clinician.

How long does it take for Lanoxin to show benefit in heart failure?

Clinical improvement in symptoms such as reduced fatigue and dyspnea may be observed within a few days to weeks, once therapeutic blood levels are achieved.

Are there any special considerations for patients with atrial fibrillation undergoing cardioversion?

Digoxin can help control ventricular rate before and after cardioversion, but its effect on the AV node may mask underlying rhythm changes. Continuous ECG monitoring is advised during the peri-procedural period.

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