Heart Failure/Atrial Fibrillation medicine from Foxgloves. Once a mainstay heart drug, but superseded by safer drugs that extend life.

[AussieNeil]

'In the modern era, digoxin was considered, for many years, the mainstay of treatment for people with heart failure. However, this has changed over the last decade as it has been replaced as first-line treatment with other medicines which are generally safer to use and known to improve patient survival.

Evidence from clinical trials found treatment with digoxin did not reduce mortality in people with heart failure. The drug is now recommended as second-line treatment for people with severe heart failure who also have heart rhythm problems.

Digoxin was first isolated from the foxglove plant by Dr Sydney Smith at Burroughs Wellcome in Britain in 1930.

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Digoxin is known to have a narrow safety margin – the dose used for effective treatment is close to the dose that can cause adverse effects. At the correct dosage digoxin will reduce a patient’s heart palpitations and improve their symptoms of heart failure (which includes reducing shortness of breath).

If the dosage is too high, patients can experience delirium and depression, and it can adversely affect heart rhythm (arrhythmia), causing palpitations (or worse, death).

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Digoxin interacts with a range of other medicines that people may be taking, including St John’s wort, which reduces the effectiveness of digoxin.

Digoxin (even at therapeutic doses) can cause nausea, vomiting, diarrhoea, visual disturbances (such as blurred vision and xanthopsia (where you see yellow/green halos around objects), drowsiness, dizziness, headache, fatigue and rash.'

Andrew McLachlan, Professor of Pharmacy (Aged Care), University of Sydney provides more detail on how this still very commonly prescribed drug (350,000 scripts per year in Australia) and derived from a garden plant, is being replaced by drugs developed and proven to be safer to use and that also prolong survival: theconversation.com/weekly-...

Neil

Photo: I found this unusual looking Gland Flower - Adenanthos terminalis, growing in the scrub. Thanks to Jay as usual for identifying it.

[PaulaS Volunteer]

Interesting article, Neil - especially the theory that Van Gogh might have been suffering from Digitalis (foxglove plant) poisoning.

In my nursing days, digoxin was the standard drug for many heart conditions (even though we were aware of its dangers). It's very sobering to hear it doesn't actually reduce mortality in people with heart failure (though it might be helpful for certain conditions). All those digoxin tablets we used to give out on medicine rounds! We used to think it was a good example of a drug being derived from a nice natural source... Maybe not such a good example after all..

Good to hear that it's now been replaced by other drugs that are safer and more effective.

Thanks for posting this,

Paula