| Mechanism | * Inhibits Na/K pump - ↑ intracellular Na conc inhibiting Na/Ca pump * ↓ Ca pumped out of cell - ↑ force of contraction * ↑ vagal activity, ↓ HR/AV node conduction |
| Typical Dose | 125-250 micrograms |
| Indications | * HF * Supraventricular Arrhythmias (esp fast AF aim for HR <100) |
| Contra-indications | * Complete Heart Block * HOCM * WPW syndrome |
| Side-effects | Common: nausea, vomiting, anorexia, visual disturbances Rarely: confusion, hallucinations |
| Interactions | * Amiodarone/propafenone/quinidine: antiarrhythmics ↑ risk of digoxin toxicity * CCBs: ↑ risk of digoxin toxicity * Diuretics: hypokalaemia can ↑ risk of toxicity |
| Elimination | Excreted via the kidneys |
| Additional Notes | * Can cause ST Depression - digoxin effect * Weak +ve inotrope, half life of 36 hours |