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DIGOXIN 0.25MG TABLETS

Active substance(s): DIGOXIN

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Package Leaflet: Information for the User
®

Lanoxin 0.25mg tablets
(digoxin)

Read all of this leaflet carefully before you start
using this medicine.
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor
or pharmacist.
This medicine has been prescribed for you. Do
not pass it on to others. It may harm them, even if
their symptoms are the same.
If any of the side effects gets serious, or if you
notice any side effects not listed in this leaflet,
please tell your doctor or pharmacist.
The name of your medicine is Lanoxin 0.25mg tablets
but it will be referred to as Lanoxin throughout this
leaflet.
In this leaflet:
1. What Lanoxin is and what it is used for
2. Before you take Lanoxin
3. How to take Lanoxin
4. Possible side effects
5. How to store Lanoxin
6. Further information

1. What Lanoxin is and what it is used for
Lanoxin contains a medicine called digoxin. This
belongs to a group of medicines called ‘cardiac
glycosides’. They work by slowing down the rate
while increasing the force of your heart when it beats.
It is used to treat certain heart problems, such as:
heart failure
This is when your heart muscle can’t pump
strongly enough to supply blood around your
whole body. It is not the same as a heart attack
and does not mean that your heart stops.
certain types of irregular heart beats
These include ‘atrial flutter’ or ‘fibrillation’. They
are caused by problems in the way the upper
chambers of your heart send electrical signals.
They cause your heart to beat too fast or in an
uneven way.

2. Before you take Lanoxin
Do not take Lanoxin if:
you are allergic (hypersensitive) to digoxin,
digitoxin or any of the other ingredients of
Lanoxin (listed in Section 6)
you have been told that you have any of the
following heart problems:
‘Second degree’ or ‘intermittent complete
heart block’
Certain types of ‘supraventricular
arrhythmias’
‘Ventricular tachycardia’ or ‘Ventricular
fibrillation’
‘Hypertrophic obstructive cardiomyopathy’
Your doctor should have checked your heart problem
and decided that this medicine will help you. If you
are not sure, talk to your doctor or pharmacist before
taking Lanoxin.
Take special care with Lanoxin
Check with your doctor or pharmacist before using
your medicine if:
you have recently had a heart attack (myocardial
infarction)
you have been told that you have low potassium
or magnesium levels in your blood (hypokalaemia
or hypomagnesaemia)
you have been told that you have high calcium
levels in your blood (hypercalcaemia)
you have a heart problem caused by a lack of
vitamin B, known as ‘Beri-Beri disease’
you have kidney problems
you have a lung problem
you have thyroid problems
you have digestion problems.
If you are not sure if any of the above apply to you,
talk to your doctor or pharmacist before taking this
medicine. Your doctor may change your dose or you
may need a different medicine.

Taking other medicines
Please tell your doctor or pharmacist if you are taking
or have recently taken any other medicines. This
includes medicines obtained without a prescription
and herbal products. In particular tell your doctor or
pharmacist if:
you have taken either digoxin or digitoxin in the
last 2 weeks. Your doctor may need to change
your dose.
Taking Lanoxin with other medicines can change how
they work or how Lanoxin works. Tell your doctor or
pharmacist if you are taking any of the following:
medicines for stomach problems, including
indigestion, diarrhoea and being sick (vomiting)
medicines for heart problems, including high
blood pressure (hypertension) and irregular heart
beat (arrhythmia)
medicines for breathing problems, like asthma
medicines for cancer
medicines for epilepsy
medicines for anxiety or depression
medicines for bacterial infections (antibiotics)
medicines for fungal infections (antifungals)
medicines for high cholesterol
medicines for preventing organ transplant
rejection
medicines for problems with your immune system
medicines for preventing blood clots during
kidney dialysis
water tablets (diuretics)
laxatives
steroids
anaesthetics
the herbal remedy St John’s Wort (Hypericum
perforatum). This should not be taken, when
taking Lanoxin. If you already take St John’s
Wort, speak to your doctor, as soon as possible,
before you stop taking St John’s Wort.
If you are not sure if any of the above applies to you,
talk to your doctor or pharmacist before taking
Lanoxin
Taking Lanoxin with food
Lanoxin can be taken with most foods. However, you
should avoid taking it with foods that are high in fibre
(e.g. brown bread, cereals, fruit, vegetables and
pulses), also known as ‘roughage’, as the amount of
Lanoxin absorbed into the body may be reduced.
Pregnancy and breast-feeding
Talk to your doctor before taking this medicine if you
are pregnant, might become pregnant or are breastfeeding.
Driving and using machines
You may feel dizzy, tired, have a headache or get
blurred vision while taking Lanoxin. If this happens,
do not drive or use any tools or machines.
Important information about some of the
ingredients of Lanoxin
This medicine contains lactose. If you have been told
by your doctor that you have an intolerance to some
sugars, talk to your doctor before taking Lanoxin.

3.

How to take Lanoxin

Always take Lanoxin exactly as your doctor has told
you. You should check with your doctor or pharmacist
if you are not sure.
Your doctor will have decided how much Lanoxin is
right for you:
It depends on what heart problem you have and
how serious it is.
It also depends on your age, weight and how well
your kidneys work.
Your dose may go up or down depending on how
you respond to the medicine. Your doctor will do
checks to see how well the medicine is working.
These may involve blood and urine tests.

Taking this medicine
Tablets should be swallowed whole.
You usually take this medicine in two stages:
Stage 1 - loading dose
The loading dose gets your Lanoxin levels up to
the correct level quickly. You will either:
- take one large single dose and then begin
your maintenance dose or
- take a smaller dose each day for a week and
then begin your maintenance dose.
Stage 2 - maintenance dose
After your loading dose you will take a much
smaller dose every day, until your doctor tells you
to stop.
Adults and children over 10 years
loading dose
- Usually between 0.75 and 1.5mg (3 and 6
tablets) as a single dose.
- For some patients, this may be given in
divided doses 6 hours apart.
- Alternatively, between 0.25 and 0.75mg (1
and 3 tablets) may be given each day for a
week.
maintenance dose
- Your doctor will decide this, depending on
your response to Lanoxin.
- It is usually between 0.125 and 0.25mg daily.
- You may take a lower strength tablet for the
maintenance dose.
Children under 10 years
loading dose
- This is worked out using your child’s weight.
- Usually between 0.025 and 0.045mg per kg
of body weight.
- This should be given in divided doses
between 4 and 8 hours apart.
maintenance dose
- The doctor will decide this, depending on
your child’s response to Lanoxin.
- It is usually a 1/5 (fifth) or a 1/4 (quarter) of
the loading dose, to be taken daily.
If you use more Lanoxin than you should
If you take too much or if somebody else takes your
medicine by mistake, go to the hospital
immediately. You may get any of the side effects
and symptoms listed in Section 4, but these can be
serious.
If you forget to use Lanoxin
If you forget to take a dose, take it as soon as
you remember. However, if it is almost time for
the next dose, skip the missed dose.
Do not take a double dose to make up for the one
that you missed.
If you stop using Lanoxin
Do not stop taking this medicine, as your heart
problem may get worse. Talk to your doctor if you
want to stop.
If you have any further questions on taking this
medicine, ask your doctor or pharmacist.

4. Possible side effects
Like all medicines, Lanoxin can cause side effects,
although not everybody gets them. In general, the
side effects tend to happen if the dose you are taking
is too high, your doctor may adjust your dose.
Tell your doctor immediately if:
you have palpitations, chest pain, shortness of
breath or sweating.
These can be symptoms of a serious heart problem
caused by new irregular heart beats. If these happen,
tell your doctor immediately.
Other side effects that you should tell your doctor
about, include:
Common (affects less than 1 in 10 people)
slow or irregular heart rate
feeling sick, being sick or diarrhoea
skin rash that may be itchy
drowsiness or dizziness
visual disturbances, with blurred or yellow-green
sight

Uncommon (affects less than 1 in 100 people)
depression.
Very rare (affects less than 1 in 10,000 people)
bruising or bleeding more easily than normal
stomach pain caused by lack of blood supply or
damage to your intestines
mental disturbances, you may feel confused,
indifferent or unable to judge clearly
weakness, tiredness or a general feeling of being
unwell
breast enlargement in men
loss of appetite
headache
Lanoxin can very rarely cause serious irregular
heart rates. Your doctor may do regular checks to
make sure Lanoxin is working safely for you.
Reporting of side effects
If you get any side effects, talk to your doctor,
pharmacist or nurse. This includes any possible side
effects not listed in this leaflet. You can also report
side effects directly via the Yellow Card Scheme at:
www.mhra.gov.uk/yellowcard
By reporting side effects, you can help provide more
information on the safety of this medicine.

5. How to store Lanoxin
Keep out of the sight and reach of children.
Do not take your tablets after the expiry date which is
stated on the carton and blister label after ‘Exp’. The
expiry date refers to the last day of that month.
Do not store above 25°C.
Store in the original pack in order to protect from
moisture.
If your tablets become discoloured or show any signs
of deterioration, seek the advice of your pharmacist.
Medicines should not be disposed of via wastewater
or household waste. Ask your pharmacist how to
dispose of medicines no longer required. These
measures will help to protect the environment.

6. Further information
What Lanoxin contains
The active ingredient is digoxin. Each tablet contains
0.25mg digoxin.
The other ingredients are lactose, corn starch, rice
starch, corn starch hydrolysed and magnesium
stearate.
What Lanoxin looks like and contents of the pack
Lanoxin is round, white tablet engraved with ‘DO25’
on one side with a line engraved down the middle
and plain on the other side.
Lanoxin is available in blister packs containing 30
tablets.
Manufactured by: Aspen Bad Oldesloe GmbH,
lndustriestrasse 32-36, D-23843 Bad Oldesloe,
Germany.
Procured from within the EU and repackaged by
the Product Licence holder: B&S Healthcare,
Unit 4, Bradfield Road, Ruislip, Middlesex, HA4 0NU,
UK.
Lanoxin® 0.25mg tablets
PL 18799/2471
Leaflet date: 26.08.2015

POM

Package Leaflet: Information for the User

Digoxin 0.25mg tablets
Read all of this leaflet carefully before you start
using this medicine.
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor
or pharmacist.
This medicine has been prescribed for you. Do
not pass it on to others. It may harm them, even if
their symptoms are the same.
If any of the side effects gets serious, or if you
notice any side effects not listed in this leaflet,
please tell your doctor or pharmacist.
The name of your medicine is Digoxin 0.25mg tablets
but it will be referred to as Digoxin throughout this
leaflet.
In this leaflet:
1. What Digoxin is and what it is used for
2. Before you take Digoxin
3. How to take Digoxin
4. Possible side effects
5. How to store Digoxin
6. Further information

1. What Digoxin is and what it is used for
Digoxin contains a medicine called digoxin. This
belongs to a group of medicines called ‘cardiac
glycosides’. They work by slowing down the rate
while increasing the force of your heart when it beats.
It is used to treat certain heart problems, such as:
heart failure
This is when your heart muscle can’t pump
strongly enough to supply blood around your
whole body. It is not the same as a heart attack
and does not mean that your heart stops.
certain types of irregular heart beats
These include ‘atrial flutter’ or ‘fibrillation’. They
are caused by problems in the way the upper
chambers of your heart send electrical signals.
They cause your heart to beat too fast or in an
uneven way.

2. Before you take Digoxin
Do not take Digoxin if:
you are allergic (hypersensitive) to digoxin,
digitoxin or any of the other ingredients of Digoxin
(listed in Section 6)
you have been told that you have any of the
following heart problems:
‘Second degree’ or ‘intermittent complete
heart block’
Certain types of ‘supraventricular
arrhythmias’
‘Ventricular tachycardia’ or ‘Ventricular
fibrillation’
‘Hypertrophic obstructive cardiomyopathy’
Your doctor should have checked your heart problem
and decided that this medicine will help you. If you
are not sure, talk to your doctor or pharmacist before
taking Digoxin.
Take special care with Digoxin
Check with your doctor or pharmacist before using
your medicine if:
you have recently had a heart attack (myocardial
infarction)
you have been told that you have low potassium
or magnesium levels in your blood (hypokalaemia
or hypomagnesaemia)
you have been told that you have high calcium
levels in your blood (hypercalcaemia)
you have a heart problem caused by a lack of
vitamin B, known as ‘Beri-Beri disease’
you have kidney problems
you have a lung problem
you have thyroid problems
you have digestion problems.
If you are not sure if any of the above apply to you,
talk to your doctor or pharmacist before taking this
medicine. Your doctor may change your dose or you
may need a different medicine.

Taking other medicines
Please tell your doctor or pharmacist if you are taking
or have recently taken any other medicines. This
includes medicines obtained without a prescription
and herbal products. In particular tell your doctor or
pharmacist if:
you have taken either digoxin or digitoxin in the
last 2 weeks. Your doctor may need to change
your dose.
Taking Digoxin with other medicines can change how
they work or how Digoxin works. Tell your doctor or
pharmacist if you are taking any of the following:
medicines for stomach problems, including
indigestion, diarrhoea and being sick (vomiting)
medicines for heart problems, including high
blood pressure (hypertension) and irregular heart
beat (arrhythmia)
medicines for breathing problems, like asthma
medicines for cancer
medicines for epilepsy
medicines for anxiety or depression
medicines for bacterial infections (antibiotics)
medicines for fungal infections (antifungals)
medicines for high cholesterol
medicines for preventing organ transplant
rejection
medicines for problems with your immune system
medicines for preventing blood clots during
kidney dialysis
water tablets (diuretics)
laxatives
steroids
anaesthetics
the herbal remedy St John’s Wort (Hypericum
perforatum). This should not be taken, when
taking Digoxin. If you already take
St John’s Wort, speak to your doctor, as soon as
possible, before you stop taking St John’s Wort.
If you are not sure if any of the above applies to you,
talk to your doctor or pharmacist before taking
Digoxin
Taking Digoxin with food
Digoxin can be taken with most foods. However, you
should avoid taking it with foods that are high in fibre
(e.g. brown bread, cereals, fruit, vegetables and
pulses), also known as ‘roughage’, as the amount of
Digoxin absorbed into the body may be reduced.
Pregnancy and breast-feeding
Talk to your doctor before taking this medicine if you
are pregnant, might become pregnant or are breastfeeding.
Driving and using machines
You may feel dizzy, tired, have a headache or get
blurred vision while taking Digoxin. If this happens,
do not drive or use any tools or machines.
Important information about some of the
ingredients of Digoxin
This medicine contains lactose. If you have been told
by your doctor that you have an intolerance to some
sugars, talk to your doctor before taking Digoxin.

3.

How to take Digoxin

Always take Digoxin exactly as your doctor has told
you. You should check with your doctor or pharmacist
if you are not sure.
Your doctor will have decided how much Digoxin is
right for you:
It depends on what heart problem you have and
how serious it is.
It also depends on your age, weight and how well
your kidneys work.
Your dose may go up or down depending on how
you respond to the medicine. Your doctor will do
checks to see how well the medicine is working.
These may involve blood and urine tests.

Taking this medicine
Tablets should be swallowed whole.
You usually take this medicine in two stages:
Stage 1 - loading dose
The loading dose gets your Digoxin levels up to
the correct level quickly. You will either:
- take one large single dose and then begin
your maintenance dose or
- take a smaller dose each day for a week and
then begin your maintenance dose.
Stage 2 - maintenance dose
After your loading dose you will take a much
smaller dose every day, until your doctor tells you
to stop.
Adults and children over 10 years
loading dose
- Usually between 0.75 and 1.5mg (3 and 6
tablets) as a single dose.
- For some patients, this may be given in
divided doses 6 hours apart.
- Alternatively, between 0.25 and 0.75mg (1
and 3 tablets) may be given each day for a
week.
maintenance dose
- Your doctor will decide this, depending on
your response to Digoxin.
- It is usually between 0.125 and 0.25mg daily.
- You may take a lower strength tablet for the
maintenance dose.
Children under 10 years
loading dose
- This is worked out using your child’s weight.
- Usually between 0.025 and 0.045mg per kg
of body weight.
- This should be given in divided doses
between 4 and 8 hours apart.
maintenance dose
- The doctor will decide this, depending on
your child’s response to Digoxin.
- It is usually a 1/5 (fifth) or a 1/4 (quarter) of
the loading dose, to be taken daily.
If you use more Digoxin than you should
If you take too much or if somebody else takes your
medicine by mistake, go to the hospital
immediately. You may get any of the side effects
and symptoms listed in Section 4, but these can be
serious.
If you forget to use Digoxin
If you forget to take a dose, take it as soon as
you remember. However, if it is almost time for
the next dose, skip the missed dose.
Do not take a double dose to make up for the one
that you missed.
If you stop using Digoxin
Do not stop taking this medicine, as your heart
problem may get worse. Talk to your doctor if you
want to stop.
If you have any further questions on taking this
medicine, ask your doctor or pharmacist.

4. Possible side effects
Like all medicines, Digoxin can cause side effects,
although not everybody gets them. In general, the
side effects tend to happen if the dose you are taking
is too high, your doctor may adjust your dose.
Tell your doctor immediately if:
you have palpitations, chest pain, shortness of
breath or sweating.
These can be symptoms of a serious heart problem
caused by new irregular heart beats. If these happen,
tell your doctor immediately.
Other side effects that you should tell your doctor
about, include:
Common (affects less than 1 in 10 people)
slow or irregular heart rate
feeling sick, being sick or diarrhoea
skin rash that may be itchy
drowsiness or dizziness
visual disturbances, with blurred or yellow-green
sight

Uncommon (affects less than 1 in 100 people)
depression.
Very rare (affects less than 1 in 10,000 people)
bruising or bleeding more easily than normal
stomach pain caused by lack of blood supply or
damage to your intestines
mental disturbances, you may feel confused,
indifferent or unable to judge clearly
weakness, tiredness or a general feeling of being
unwell
breast enlargement in men
loss of appetite
headache
Digoxin can very rarely cause serious irregular
heart rates. Your doctor may do regular checks to
make sure Digoxin is working safely for you.
Reporting of side effects
If you get any side effects, talk to your doctor,
pharmacist or nurse. This includes any possible side
effects not listed in this leaflet. You can also report
side effects directly via the Yellow Card Scheme at:
www.mhra.gov.uk/yellowcard
By reporting side effects, you can help provide more
information on the safety of this medicine.

5. How to store Digoxin
Keep out of the sight and reach of children.
Do not take your tablets after the expiry date which is
stated on the carton and blister label after ‘Exp’. The
expiry date refers to the last day of that month.
Do not store above 25°C.
Store in the original pack in order to protect from
moisture.
If your tablets become discoloured or show any signs
of deterioration, seek the advice of your pharmacist.
Medicines should not be disposed of via wastewater
or household waste. Ask your pharmacist how to
dispose of medicines no longer required. These
measures will help to protect the environment.

6. Further information
What Digoxin contains
The active ingredient is digoxin. Each tablet contains
0.25mg digoxin.
The other ingredients are lactose, corn starch, rice
starch, corn starch hydrolysed and magnesium
stearate.
What Digoxin looks like and contents of the pack
Digoxin is round, white tablet engraved with ‘DO25’
on one side with a line engraved down the middle
and plain on the other side.
Digoxin is available in blister packs containing 30
tablets.
Manufactured by: Aspen Bad Oldesloe GmbH,
lndustriestrasse 32-36, D-23843 Bad Oldesloe,
Germany.
Procured from within the EU and repackaged by
the Product Licence holder: B&S Healthcare,
Unit 4, Bradfield Road, Ruislip, Middlesex, HA4 0NU,
UK.
Digoxin 0.25mg tablets
PL 18799/2471
Leaflet date: 26.08.2015

POM

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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