Cardixin 0.25 mg - 40 Tablet

Treatment of mild to moderate heart failure: Loading dose Tablets: 10 to 15 mcg/kg, maintain on Tablets: 3.4 to 5.1 mcg/kg once a day.

Heart failure / AF (maintenance): typically 0.125–0.25 mg once daily Elderly, renal impairment, low body weight: use lower doses (e.g., 0.125 mg daily or every other day) Loading (digitalization): may be used in selected cases under supervision Take at the same time each day Dose adjustment required in renal impairment Monitor serum digoxin levels (typical target ~0.5–0.9 ng/mL in HF)

Common: Nausea, vomiting Loss of appetite Fatigue Dizziness Toxicity (dose-related): Arrhythmias Bradycardia Visual disturbances (yellow/green vision, halos) Confusion, delirium

Contraindications Hypersensitivity to digoxin Ventricular fibrillation Certain tachyarrhythmias without AV block Hypertrophic obstructive cardiomyopathy (relative) Precautions Narrow therapeutic index Increased toxicity risk with hypokalemia, hypomagnesemia, hypercalcemia Monitor renal function, electrolytes, and ECG Use caution in elderly and thyroid disorders

Store below 25–30°C Protect from moisture and light

Amiodarone, verapamil, diltiazem, quinidine → ↑ digoxin levels Diuretics (loop/thiazide) → electrolyte disturbances ↑ toxicity Macrolides (e.g., clarithromycin) → ↑ levels Antacids, cholestyramine → ↓ absorption St. John’s wort → ↓ levels

Pregnancy: May be used if clinically indicated Lactation: Excreted in small amounts; generally considered compatible

GLAXO SMITHKLINE