Why is this drug prescribed?

Lanoxin is used in the treatment of congestive heart failure, certain types of irregular heartbeat, and other heart problems. It improves the strength and efficiency of your heart, which leads to better circulation of blood and reduction of the uncomfortable swelling that is common in people with congestive heart failure. Lanoxin is usually prescribed along with a water pill (to help relieve swelling) and a drug called an ACE inhibitor (to further improve circulation). It belongs to a class of drugs known as digitalis glycosides.

Most important fact about this drug

You should not stop taking Lanoxin without first consulting your doctor. A sudden absence of the drug could cause a serious change in your heart function. You will probably have to take Lanoxin for a long time--possibly for the rest of your life.

How should you take this medication?

Lanoxin usually is taken once daily. To help you remember your dose, try to take it at the same time every day, for instance when brushing your teeth in the morning or going to bed at night.

Lanoxin is available in tablet, capsule, liquid, and injectable forms. If you are taking the liquid form, use the specially marked dropper that comes with it.

It's best to take this medicine on an empty stomach. However, if this upsets your stomach, you can take Lanoxin with food.

Avoid taking this medicine with high-bran/high-fiber foods, such as certain breakfast cereals.

Do not change from one brand of this drug to another without first consulting your doctor or pharmacist.

Your doctor may ask you to check your pulse rate while taking Lanoxin. Slowing or quickening of your pulse could mean you are developing side effects to your prescribed dose. The amount of Lanoxin needed to help most people is very close to the amount that could cause serious problems from overdose, so monitoring your pulse can be very important.

If you miss a dose

If you remember within 12 hours, take it immediately. If you remember later, skip the dose you missed and go back to your regular schedule. Never take 2 doses at the same time. If you miss doses 2 or more days in a row, consult your doctor.

Storage Instructions

Store this medication at room temperature in the container it came in, tightly closed, and away from moist places and direct light. Keep out of reach of children. Digitalis-type drugs such as Lanoxin are a major cause of accidental poisoning in the young.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Lanoxin.

Side effects may include:

• apathy
• blurred vision
• breast development in males
• change in heartbeat
• confusion
• diarrhea
• dizziness
• headache
• loss of appetite
• lower stomach pain
• nausea
• psychosis
• rash
• vomiting
• weakness
• yellow vision

Why should this drug not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Lanoxin or other digitalis preparations, you should not take this medication. Make sure your doctor is aware of any drug reactions you have experienced.

Lanoxin should not be taken by people with the heart irregularity known as ventricular fibrillation.

Lanoxin should not be used, alone or with other drugs, for weight reduction. It can cause irregular heartbeat and other dangerous, even fatal, reactions.

Special warnings about this medication

Your doctor will prescribe Lanoxin with caution--if at all--in the presence of certain heart disorders, including sinus node disease, AV block, certain disorders of the left ventricle, and ""Wolff-Parkinson-White syndrome." Caution is also advised if you have poor kidneys, a thyroid disorder, or an imbalance in your calcium, potassium, or magnesium levels.

Tell the doctor that you are taking Lanoxin if you have a medical emergency and before you have surgery or dental treatment.

Even if you have no symptoms, do not change your dose or discontinue the use of Lanoxin before consulting with your doctor.

Possible food and drug interactions when taking this medication

In general, you should avoid nonprescription medicines, such as antacids; laxatives; cough, cold, and allergy remedies; and diet aids, except on professional advice.

If Lanoxin is taken with certain other drugs, the effects of either can be increased, decreased, or altered. It is especially important to check with your doctor before combining Lanoxin with the following:

• Airway-opening drugs such as Proventil and Ventolin
• Alprazolam (Xanax)
• Amiloride (Midamor)
• Amiodarone (Cordarone)
• Antacids such as Maalox and Mylanta
• Antibiotics such as neomycin, tetracycline, erythromycin, and clarithromycin
• Beta-blocking blood pressure drugs such as Tenormin and Inderal
• Calcium (injectable form)
• Calcium-blocking blood pressure drugs such as Calan SR, Cardizem, and Procardia
• Certain anticancer drugs such as Neosar
• Cholestyramine (Questran)
• Colestipol (Colestid)
• Cyclosporine (Sandimmune)
• Diphenoxylate (Lomotil)
• Disopyramide (Norpace)
• Heartbeat-regulating drugs such as Quinidex
• Indomethacin (Indocin)
• Itraconazole (Sporanox)
• Kaolin-pectin
• Metoclopramide (Reglan)
• Propafenone (Rythmol)
• Propantheline (Pro-Banthine)
• Rifampin (Rifadin)
• Spironolactone (Aldactone)
• Steroids such as Decadron and Deltasone
• Succinylcholine (Anectine)
• Sucralfate (Carafate)
• Sulfasalazine (Azulfidine)
• Thyroid hormones such as Synthroid
• Water pills such as Lasix

Special information if you are pregnant or breastfeeding

The effects of Lanoxin during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Lanoxin appears in breast milk and could affect a nursing infant. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding.

Recommended dosage

Your doctor will determine your dosage based on several factors: (1) the disease being treated; (2) your body weight; (3) your kidney function; (4) your age; and (5) other diseases you have or drugs you are taking.

If you are receiving Lanoxin for the first time, you may be rapidly "digitalized" (a larger first dose may be taken, followed by smaller maintenance doses), or gradually "digitalized" (maintenance doses only), depending on your doctor's recommendation.

ADULTS - If your doctor feels you need rapid digitalization, your first few doses may be given intravenously. You'll then be switched to tablets or capsules for long-term maintenance. A typical maintenance dose might be a 0.125 milligram or 0.25 milligram tablet once daily, but individual requirements vary widely. The exact dose will be determined by your doctor, based on your needs.

CHILDREN - Infants and young children usually have their daily dose divided into smaller doses; children over age 10 need adult dosages in proportion to body weight as determined by your doctor.

Overdosage

Suspected overdoses of Lanoxin must be treated immediately. You should contact your doctor or emergency room without delay.

Symptoms of Lanoxin overdose include:

• abdominal pain
• diarrhea
• irregular heartbeat
• loss of appetite
• nausea
• very slow pulse
• vomiting

In infants and children, irregular heartbeat is the most common sign of overdose.