Lanoxin tablet: Difference between revisions

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{{Label template
{{Label template
|authorTag={{AK}}
|drugClass=Cardiac glycoside
|drugClass=Cardiac glycoside
|indication=[[heart failure]] and [[atrial fibrillation]]
|indication=[[heart failure]] and [[atrial fibrillation]]
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===Use in Patients With Preserved Left Ventricular Systolic Function===
===Use in Patients With Preserved Left Ventricular Systolic Function===
Patients with certain disorders involving heart failure associated with preserved left ventricular ejection fraction may be particularly susceptible to toxicity of the drug. Such disorders include restrictive cardiomyopathy, constrictive pericarditis, amyloid heart disease, and acute cor pulmonale. Patients with idiopathic hypertrophic subaortic stenosis may have worsening of the outflow obstruction due to the inotropic effects of digoxin. Digoxin should generally be avoided in these patients, although it has been used for ventricular rate control in the subgroup of patients with atrial fibrillation.
Patients with certain disorders involving heart failure associated with preserved left ventricular ejection fraction may be particularly susceptible to toxicity of the drug. Such disorders include restrictive cardiomyopathy, constrictive pericarditis, amyloid heart disease, and acute cor pulmonale. Patients with idiopathic hypertrophic subaortic stenosis may have worsening of the outflow obstruction due to the inotropic effects of digoxin. Digoxin should generally be avoided in these patients, although it has been used for ventricular rate control in the subgroup of patients with atrial fibrillation.
|clinicalTrials====Cardiac===
'''Arrhythmia'''( first-degree, second-degree (Wenckebach), or third-degree heart block (including asystole); atrial tachycardia with block; AV dissociation; accelerated junctional (nodal) rhythm; unifocal or multiform ventricular premature contractions (especially bigeminy or trigeminy); ventricular tachycardia; and ventricular fibrillation).
===Gastrointestinal===
anorexia, nausea, vomiting, and diarrhea
===Neurologic===
visual disturbances (blurred or yellow vision), headache, weakness, dizziness, apathy, confusion, and mental disturbances (such as anxiety, depression, delirium, and hallucination).
===Other adverse reactions===
Gynecomastia, thrombocytopenia and maculopapular rash.
|hasUsageInfo=In Progress
|hasUsageInfo=In Progress
}}
}}

Revision as of 15:10, 20 March 2014

Lanoxin tablet®
Black Box Warning
Adult Indications and Dosage
Pediatric Indications and Dosage
Contraindications
Warnings
Adverse Reactions
Drug Interactions
Use in Specific Populations
Routes and Preparations
IV Compatibility
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient information
Precautions with Alcohol
Look-Alike Drug Names
Drug Shortage Status
Price

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Abdurahman Khalil, M.D. [2]

For information about {{{genericName}}}, click here.

Disclaimer

Overview

Lanoxin tablet is a Cardiac glycoside drug that is FDA approved for the treatment of heart failure and atrial fibrillation. Adverse reactions include AV block, tachycardia, GI symptoms and visual disturbances.

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)
Off-Label Use and Dosage (Adult)

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)
Off-Label Use and Dosage (Pediatric)

Contraindications

Warnings

Adverse Reactions

Clinical Trials Experience
Postmarketing Experience

Drug Interactions

Use in Specific Populations

Pregnancy
Labor and Delivery
Nursing Mothers
Pediatric Use
Geriatric Use
Gender
Race
Renal Impairment
Hepatic Impairment
Females of Reproductive Potential and Males
Immunocompromised Patients

Routes and Preparations

Routes
Preparations

IV Compatibility

Overdosage

Pharmacology

Mechanism of Action
Structure
Pharmacodynamics
Pharmacokinetics
Nonclinical Toxicology

Clinical Studies

How Supplied

Images

Drug Images
Package and Label Display Panel

Patient Information

Patient Information from FDA

Patient Information from NLM

Look-Alike Drug Names

Price

Drug Shortage


Adult Indications and Dosage

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===FDA-Labeled Indications and Dosage (Adult)===

Template:SubsectionHeader Loading dose"': 10-15 mcg/kg half of dose administered initially, and the other two quarters are given every 6-8 hours twice.

Maintenance dose: 3.4-5.1 mcg/kg/day once daily. Template:SubsectionHeader Loading dose"': 10-15 mcg/kg half of dose administered initially, and the other two quarters are given every 6-8 hours twice.

Maintenance dose: 3.4-5.1 mcg/kg/day once daily.

===Off-Label Use and Dosage (Adult)===

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Pediatric Indications and Dosage

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===FDA-Labeled Indications and Dosage (Pediatric)===

Heart failure

Loading dose:

5-10 years old

20-45 mcg/kg Administer half the total loading dose initially, 

then ¼ the loading dose every 6 to 8 hours twice. >10 year old ' 10-15 mcg/kg Administer half the total loading dose initially, then ¼ the loading dose every 6 to 8 hours twice.

Maintenence dose:

Less than 10 years old 3.2-6.4 mcg/kg/dose twice a day. More than 10 years 3.4-5.1 mcg/kg/day

===Off-Label Use and Dosage (Pediatric)===

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Contraindications

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===Contraindications===

  • Ventricular fibrillation
  • Hypersensitivity to digoxin
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Warnings

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===Warnings===

Sinus Node Disease and AV Block

Because digoxin slows sinoatrial and AV conduction, the drug commonly prolongs the PR interval. The drug may cause severe sinus bradycardia or sinoatrial block in patients with pre-existing sinus node disease and may cause advanced or complete heart block in patients with pre-existing incomplete AV block. In such patients consideration should be given to the insertion of a pacemaker before treatment with digoxin.

Accessory AV Pathway (Wolff-Parkinson-White Syndrome)

After intravenous digoxin therapy, some patients with paroxysmal atrial fibrillation or flutter and a coexisting accessory AV pathway have developed increased antegrade conduction across the accessory pathway bypassing the AV node, leading to a very rapid ventricular response or ventricular fibrillation. Unless conduction down the accessory pathway has been blocked (either pharmacologically or by surgery), digoxin should not be used in such patients. The treatment of paroxysmal supraventricular tachycardia in such patients is usually direct-current cardioversion.

Use in Patients With Preserved Left Ventricular Systolic Function

Patients with certain disorders involving heart failure associated with preserved left ventricular ejection fraction may be particularly susceptible to toxicity of the drug. Such disorders include restrictive cardiomyopathy, constrictive pericarditis, amyloid heart disease, and acute cor pulmonale. Patients with idiopathic hypertrophic subaortic stenosis may have worsening of the outflow obstruction due to the inotropic effects of digoxin. Digoxin should generally be avoided in these patients, although it has been used for ventricular rate control in the subgroup of patients with atrial fibrillation.

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Use in Specific Populations

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===Pregnancy===

: '''[[Pregnancy category#United States|Pregnancy Category (FDA)]]'''

There is no FDA guidance on usage of {{BASEPAGENAME}} in women who are pregnant.

:'''[[Pregnancy category#Australia|Pregnancy Category (AUS)]]'''

There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of {{BASEPAGENAME}} in women who are pregnant.

===Labor and Delivery===

There is no FDA guidance on use of {{BASEPAGENAME}} during labor and delivery.

===Nursing Mothers===

There is no FDA guidance on the use of {{BASEPAGENAME}} in women who are nursing.

===Pediatric Use===

There is no FDA guidance on the use of {{BASEPAGENAME}} in pediatric settings.

===Geriatic Use===

There is no FDA guidance on the use of {{BASEPAGENAME}} in geriatric settings.

===Gender===

There is no FDA guidance on the use of {{BASEPAGENAME}} with respect to specific gender populations.

===Race===

There is no FDA guidance on the use of {BASEPAGENAME}} with respect to specific racial populations.

===Renal Impairment===

There is no FDA guidance on the use of {{BASEPAGENAME}} in patients with renal impairment.

===Hepatic Impairment===

There is no FDA guidance on the use of {{BASEPAGENAME}} in patients with hepatic impairment.

===Females of Reproductive Potential and Males===

There is no FDA guidance on the use of {{BASEPAGENAME}} in women of reproductive potentials and males.

===Immunocompromised Patients===

There is no FDA guidance one the use of {{BASEPAGENAME}} in patients who are immunocompromised.

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Overdose

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'''Please contact the National Poison Help hotline (1-800-222-1222) immediately if there is suspicion of drug poisoning or overdose.'''

===Overdose===

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Pharmacology

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===Mechanism of Action===

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===Structure===

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===Pharmacodynamics===

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===Pharmacokinetics===

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===Nonclinical Toxicology===

{{{nonClinToxic}}}

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