digoxin according to weight

[kitttycat]

Hello everyone I am reaching out again for your help.

I have been prescribed and have been taking .125 mg digoxin one time daily. The pharmacist at the drugstore told me that I was overprescribed, because this medicine is taken according to weight. It is a standard dose but there is a lower amount of .0625 mg. I weigh 136 pounds (Canadian) and the weight to take .125 mgs starts at 152 pounds.

The pharmacist wrote a note to the cardiologist. but I didn't hear anything.

I have also read that a person should take the least amount of digoxin that is effective for them.

Does anyone know anything about this. How this works?

I also take 75 mg propafernone twice daily (1/2 of 150) and my brains are in a fog all day.

I would really appreciate hearing back. Very best wishes to everyone..

[BobD Volunteer]

Propafanone (Arytmol) has its own beta blocking effect so not sure why you are on a drug to slow your heart as well. My EP took me off atenalol when he switched me from flecainide to propafanone, I know digoxin is not a beta blocker but same purpose.

[kitttycat in reply to BobD]

Bob, thanks for this information, I am going to look into.

[mesally]

Hello there, I am now on Digoxin 62.5 micrograms, reduced from the higher dose which eventually gave me some eye side effects. The lower dose. seems to do the trick just the same as the higher dose. Digoxin makes your heart beat stronger, not slower like bisoprolol, hence you might, like me, be prescribed both. I weigh 9st 2lb but didn't know about the weight issue. Best wishes

[kitttycat in reply to mesally]

Hi thanks for getting back to me. What I was told about the two is that one is fast and one is slow. I still don't know what this means. From what I gather I think it means one is strong and one is slow. I am going to ask the cardiologist about the possibility of lowering the dosage. As I have read the responses to my query, my impression is that you have to take digoxin at an amount so that your level of concentration in your body is within certain parameters. Thanks again. Best wishes to you also.

[mesally in reply to kitttycat]

Perhaps it is that your heart is beating too fast, hence bisoorolol to slow the rate, and although beating quickly it is not a strong beat, hence the digoxin to strengthen the beat and improve your heart that way?

[maxred1]

Well I take daily 1x 0.25mg, and 62.5 mcg. I also take 10mg Bisoprolol. Used to be 17.5mg!! I have not heard about this relating to weight. My dosage has not changed in7 years, and I get regular cardio reviews. Think he may be talking rubbish. (The pharma). Go with your cardio advice, and your own knowledge

[kitttycat in reply to maxred1]

Hi, thanks for getting back. I think maybe its about body distribution. But I am going to follow up with the cardiologist. I am investigating. thanks again.

[Tapanac]

I haven’t heard about digoxin according to weight (only one is anticoagulants under 60kgs or over 80). My doctor said digoxin is not a rate or rhythm control drug, just supposed to maker your heart stronger xx

[kitttycat in reply to Tapanac]

Hi thanks for your note. I am investigating more. best wishes.

[Snowgirl65]

I don't know much about the weight issue, but my electrophysiologist had me stay in the hospital for a few days when he put me on digoxin in order to judge the dosage. I had no problems with the drug.

[kitttycat in reply to Snowgirl65]

thanks, for this information. Thanks for getting back to me.

[Desanthony in reply to Snowgirl65]

I would have thought starting on the lower dose and sticking with it if it worked would be best. I was started on the higher dose but had problems with it - didn’t realise there was a lower dose until a pharmacist friend of mine offered to get me some when I was running low and she asked me if I was taking the lower dose like her Dad. I immediately asked to be changed to the lower dose and it was much better for me. Though haven’t taken it since my first successful cardio version just apixaban.

[kitttycat in reply to Desanthony]

Hello, thanks for your note, I think also that a lower dose should come first. I am going to be speaking to the cardiologist. thanks again

[Goldenre]

I also take 0.125mg digoxin. My dig level is 5 which is low but it's still therapeutic . Just make sure they are monitoring your dig levels. Too much can cause rhythm irregularities.

[kitttycat in reply to Goldenre]

Thanks for getting back to me. I will check this out. I am learning more all the time. best wishes

[kitttycat in reply to Goldenre]

Hi again, what test do they use to monitor digoxin levels. Would you be able to let me know. thanks. again.

[Goldenre in reply to kitttycat]

mine was 0.5, low but still therapeutic. Hope this info answers your question.

Claudia

Digoxin level

Normal range: 0.8 - 2.0 mcg/L

0.5

Low

Verified by repeat analysis. FAB Anti-Digoxin (Digibind(R)) in serum/plasma of patients under toxicity therapy may interfere with the digoxin immunoassay. Note: Patients with levels as low as 0.5 ng/mL may experience similar benefits regarding symptoms of heart failure, improvement in LVEFs, and increased treadmill time compared with patients with moderate (1.0 to 1.2 ng/mL) to high (more than 1.2 ng/mL) serum digoxin concentrations. (Heidenreich, P, Bozkurt, B, Aguilar, D. et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2022 May, 79 (17) e263-e421; Morris SA, Hatcher HF, Reddy DK. Digoxin therapy for heart failure: an update. Am Fam Physician. 2006 Aug 15;74(4):613-8)

[Silvasava]

Been on 125mcg of Digoxin but I checked and old patient safety leaflets I had and I was on 62.5mcg. I've never been 150lbs, my max was 144, now I'm 129 so will be having words either with doctor or HF nurse. Thank you for your post otherwise I'd have just carried on! Need to get it clarified.

[kitttycat in reply to Silvasava]

This is interesting information and this is what I am trying to find out. Thanks for getting back to me. I would be interested in knowing what they say. I will also be following up.

[Offcut]

I am now on 125mg but was on 250mg. I have a had a love hate relationship with Digoxin since 1992. I was admitted to A&E with double Pneumonia and Severe AF with a very fast pulse. I was given Digoxin to stabilise my heartrate. However, they were checking my heart and pulse at the same time every 4 hours. 7 days into my stay they lost my pulse (Well could not feel it) Bit of a surprise when a crash team is around your bed!) At that point I was taken off them and it all settled down best it could with my conditions?

I have had times were intravenous Digoxin got my extreme heartrate incidents down to safe levels but I do have a high- and low-level Digoxin prescribed over the years and sometimes I am told to take a break from it because it can drop my BP and pulse down too much? But I am sure I will never be free of Digoxin. I invested in a O2 heartrate monitor that goes on my finger and check my BP regularly so as long it is within "my normal" I stick with the level I have.

Be Well

[kitttycat in reply to Offcut]

Hello Offcut, you certainly have had a long history with Digoxin. It sounds like you have been through a lot with the many afib changes and changes in prescription amounts. I hope you are doing well now. Thank you for getting back to me. best wishes.

[Offcut in reply to kitttycat]

I have a complicated health history AF is just one of them. I have had 9 CV and 3 Ablations and still in AF!