Generic Lanoxin (Digoxin)

Introduction

Lanoxin is a cardiac glycoside medication whose active ingredient is digoxin. It is supplied as a .25 mg oral tablet and belongs to the class of positive-inotropic agents. The primary approved uses are for rate control in chronic atrial fibrillation and for symptomatic relief of heart failure with reduced ejection fraction. Digoxin is also listed in official formularies for specific arrhythmias such as atrial flutter and for certain cases of supraventricular tachycardia when other therapies are unsuitable.

What is Lanoxin?

Lanoxin is the commercial name for a tablet containing the cardiac glycoside digoxin. The drug was first isolated from the foxglove plant (Digitalis lanata) in the s and has been used for more than eight decades to improve cardiac contractility. The medication is manufactured by several licensed pharmaceutical companies; one widely distributed version is produced by GlaxoSmithKline.

Lanoxin is the generic version of well-known medications, containing the active compound digoxin. Our online pharmacy provides this generic alternative as a cost-effective treatment option.

Brand names that contain digoxin include Lanoxin, Crystacaps, and Digoxin-M (among others).

How Lanoxin Works

Digoxin inhibits the sodium-potassium ATP-ase pump in myocardial cells. This inhibition raises intracellular sodium, which indirectly increases calcium entry via the sodium-calcium exchanger. The higher intracellular calcium enhances the force of cardiac muscle contraction (positive inotropy).

In the atrioventricular (AV) node, digoxin increases vagal tone, slowing conduction and thereby reducing ventricular rate during atrial fibrillation. The onset of clinical effect after oral administration is typically 30 minutes to 2 hours; peak plasma concentrations occur at about 1-2 hours. The drug’s half-life ranges from 36 to 48 hours in patients with normal renal function, and it is eliminated primarily by the kidneys.

Conditions Treated with Lanoxin

• Chronic atrial fibrillation (rate control): Digoxin reduces ventricular response by enhancing AV-node refractory period, improving symptoms such as palpitations and dyspnoea.
• Heart failure with reduced ejection fraction (HFrEF): The positive inotropic effect increases stroke volume and cardiac output, leading to modest reductions in hospitalisation for heart-failure exacerbations.

These indications are supported by FDA-approved labeling and are reflected in major clinical guidelines (e.g., American Heart Association/American College of Cardiology).

Off-Label and Investigational Uses of Lanoxin

• Severe, refractory supraventricular tachycardia (SVT): Small case series have reported successful conversion of SVT to sinus rhythm when conventional agents failed. Evidence remains limited and safety data are incomplete.
• Atrioventricular nodal re-entrant tachycardia (AVNRT) in patients with contraindications to ablation: Observational data suggest digoxin can decrease episodes, but it is not a first-line recommendation.

These applications have not received regulatory approval. Use should occur only under direct supervision of a qualified healthcare provider, with careful monitoring of serum digoxin concentration and renal function.

Is Lanoxin the Right Medication for You?

Lanoxin is appropriate for adults with documented chronic atrial fibrillation who require ventricular-rate control and for patients with symptomatic HFrEF who remain stable on optimal guideline-directed therapy. It is especially useful when beta-blockers or calcium-channel blockers are contraindicated or not tolerated.

Contra-indications include:

• Known hypersensitivity to digoxin or any excipient in the tablet.
• Uncontrolled ventricular arrhythmias (e.g., ventricular tachycardia).
• Advanced atrioventricular block without a pacemaker.
• Severe renal impairment (eGFR < 30 mL/min/1.73 m²) without dose adjustment.

Patients with electrolyte disturbances (hypokalaemia, hypomagnesaemia) are also at heightened risk of toxicity and should have these abnormalities corrected before initiating therapy.

Risks, Side Effects, and Interactions

Common

• Nausea, vomiting, diarrhoea
• Blurred or yellow-green vision (chromatopsia)
• Fatigue, dizziness, headache

Rare

• Skin rash or pruritus
• Anorexia, weight loss
• Mood changes (e.g., depression, irritability)

Serious

• Cardiac arrhythmias (e.g., premature ventricular contractions, atrial tachycardia with block, ventricular fibrillation)
• Severe bradycardia or heart block
• Life-threatening hyperkalaemia, especially in renal failure

Drug-Drug Interactions

• Amiodarone, quinidine, verapamil, diltiazem: increase digoxin serum levels by reducing clearance.
• Loop diuretics (furosemide, torsemide): may cause hypokalaemia, potentiating toxicity.
• Macrolide antibiotics (erythromycin, clarithromycin) and certain antifungals (ketoconazole): raise digoxin concentrations.
• St. John’s wort: induces P-glycoprotein, lowering digoxin exposure.

Drug-Food Interactions

• High-fat meals have minimal effect, but large amounts of bran, soy, or fiber can reduce absorption.
• Caffeine does not significantly alter digoxin levels but may exacerbate tachyarrhythmias in sensitive individuals.

Patients should avoid self-adjusting doses and always discuss new medications, supplements, or dietary changes with their prescriber.

Use: Dosing, Missed Dose, Overdose

Standard dosing for adults with atrial fibrillation or heart failure typically starts at .125 mg to .25 mg once daily, adjusted to serum digoxin concentration (target .5-.9 ng/mL) and renal function. Elderly patients or those with impaired renal clearance often require the lower initiation dose.

Missed dose: If a dose is missed and the scheduled time is more than 12 hours away, take the tablet as soon as remembered. Do not double-dose to catch up.

Overdose: Symptoms may include severe nausea, vomiting, visual disturbances, and life-threatening arrhythmias. Seek emergency medical attention immediately. Treatment may involve activated charcoal, electrolyte correction, and administration of digoxin-specific antibody fragments (Digibind) in severe cases.

Practical precautions:

• Take the tablet with a glass of water, preferably at the same time each day.
• Food does not need to be avoided, but consistent timing relative to meals helps maintain stable levels.
• Alcohol can precipitate arrhythmias; limit intake.
• Operating heavy machinery or driving should be postponed until the individual knows how digoxin affects their alertness and vision.

FAQ

• Is it safe to travel internationally with Lanoxin?

  • Yes, provided the medication remains in its original container, is stored at room temperature, and the traveler carries a copy of the prescription or a physician’s letter if required by customs authorities.

• Can I take Lanoxin with over-the-counter antihistamines?

  • Most non-sedating antihistamines have no significant interaction, but some first-generation agents (e.g., diphenhydramine) may increase the risk of bradycardia. Consult a pharmacist before combining them.

• What does the tablet look like?

  • The .25 mg Lanoxin tablet is typically round, peach-colored, and bears the imprint “L-25” on one side and the manufacturer’s logo on the other.

• Are there any inactive ingredients that could cause allergies?

  • Common excipients include lactose, microcrystalline cellulose, and magnesium stearate. Patients with known lactose intolerance or specific excipient allergies should verify the formulation with the pharmacy.

• How should Lanoxin be stored in hot climates?

  • Keep the tablets in a cool, dry place away from direct sunlight. If ambient temperature exceeds 30 °C for prolonged periods, store the medication in a temperature-controlled container or a refrigerator (do not freeze) and allow it to reach room temperature before use.

• Does digoxin affect drug testing for employment?

  • Digoxin is not screened for in standard occupational drug tests. However, if a specialized cardiac medication panel is requested, the presence of digoxin may be reported.

• Can pregnant women use Lanoxin?

  • Digoxin is classified as Pregnancy Category C (USA) and B (EU). It crosses the placenta but is sometimes used when the benefit outweighs potential risk, such as in maternal heart failure. Use only under strict medical supervision.

• What is the difference between Lanoxin and other brand names like Crystacaps?

  • The active ingredient, digoxin, and the .25 mg strength are identical. Differences lie in tablet colour, imprint, and manufacturer. Bioavailability is comparable across approved brands.

• How long does it take for side effects to resolve after stopping the medication?

  • Because digoxin’s half-life is 36-48 hours, most adverse effects diminish within 2-3 days after discontinuation, provided renal function is normal. Persistent symptoms should be evaluated promptly.

• Is serum digoxin monitoring necessary for every patient?

  • Routine monitoring is recommended after initiating therapy, after dose changes, and in patients with renal impairment, electrolyte disturbances, or concomitant interacting drugs.

• Can I split a .25 mg tablet to adjust the dose?

  • The tablet is not scored and splitting can lead to dose inaccuracy. If a lower dose is required, a prescriber should issue a prescription for the appropriate lower-strength tablet.

Glossary

Positive-inotropic agent

A drug that increases the force of heart muscle contraction, thereby improving cardiac output.

Therapeutic window

The plasma concentration range in which a medication is effective without causing unacceptable toxicity.

Serum digoxin concentration (SDC)

The measured amount of digoxin in the blood, expressed in nanograms per milliliter (ng/mL), used to guide dosing and avoid toxicity.

Electrolyte disturbance

An abnormal level of ions such as potassium or magnesium in the blood, which can affect heart rhythm and drug safety.

Buying Lanoxin from Our Online pharmacy

Lanoxin is available for purchase through our online pharmacy, which offers a reliable and discreet channel for obtaining this essential cardiac medication.

• Affordable pricing: The generic formulation is sold at a cost close to manufacturer pricing, reducing the financial burden for patients.
• Verified quality: All tablets are sourced from licensed, audited suppliers that meet stringent regulatory standards.
• Guaranteed delivery: Orders are shipped discreetly, with options for express delivery (approximately 7 days) or regular airmail (around 3 weeks). Packaging is plain and privacy-focused.
• International access: Our pharmacy broker service partners with overseas licensed pharmacies, enabling patients in regions with limited local supply to obtain Lanoxin safely.

By choosing our service, patients gain a cost-effective, private, and trustworthy way to receive their medication when conventional pharmacy options are unavailable or financially prohibitive.

Disclaimer

The information presented about Lanoxin is intended for general educational purposes and does not substitute professional medical advice. Treatment decisions, including any off-label considerations, should be made under the guidance of a qualified healthcare professional. Readers are presumed to be competent adults capable of making informed health choices. Our online pharmacy provides access to Lanoxin for individuals who encounter limited availability through traditional pharmacy channels or who seek affordable generic alternatives. Always discuss initiation, dosage adjustments, or discontinuation of any medication with your healthcare provider.