Tell your doctor about all prescription, non-prescription, illegal, recreational, herbal, nutritional, or dietary drugs you re taking, especially acarbose prandase, precose anticoagulants blood thinners such as warfarin coumadin, jantoven antifungals such as fluconazole diflucan , itraconazole sporanox , and ketoconazole nizoral beta blockers such as atenolol tenormin , labetalol trandate , metoprolol lopressor, toprol xl , nadolol corgard , propranolol inderal , and timolol blocadren carbamazepine carbatrol, epitol, tegretol cimetidine tagamet digoxin lanoxin, lanoxicaps diltiazem cardizem doxazosin cardura erythromycin e.
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Take the missed dose as soon as you rememberSkip the missed dose if your next dose is less than 12 hours awayDo not take extra medicine to make up the missed dose.
Other drugs may interact with digoxinincluding prescription and over-the-counter medicinesvitaminsand herbal productsTell each of your health care providers about all medicines you use now and any medicine you start or stop using while you are taking Lanoxin.
Hypocalcemia can nullify the effects of digoxin in humansthusdigoxin may be ineffective until serum calcium is restored to normalThese interactions are related to the fact that digoxin affects contractility and excitability of the heart in a manner similar to that of calcium.
The earliest and most frequent manifestation of digoxin toxicity in infants and children is the appearance of cardiac arrhythmiasincluding sinus bradycardiaIn childrenthe use of digoxin may produce any arrhythmiaThe most common are conduction disturbances or supraventricular tachyarrhythmiassuch as atrial tachycardiawith or without blockand junctionalnodaltachycardiaVentricular arrhythmias are less commonSinus bradycardia may be a sign of impending digoxin intoxicationespecially in infantseven in the absence of first-degree heart blockAny arrhythmias or alteration in cardiac conduction that develops in a child taking digoxin should initially be assumed to be a consequence of digoxin intoxication.
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