Digoxin
Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026
Digoxin is a cardiac glycoside used for rate control in atrial fibrillation and symptomatic improvement in heart failure with reduced ejection fraction. The DIG trial showed it reduces hospitalizations but not mortality in heart failure. It has a narrow therapeutic index, requiring careful dosing and monitoring.
Exploratory record, not a reviewed medical publication.
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This generated database record has not completed a claim-level review by a qualified human medical reviewer. Bibliography links and evidence labels are not approval. The page remains available for reference and is excluded from search indexing.
What the research says.
A quick, data-only summary. The full evidence, dosing, and sources are below.
Digoxin is a cardiac glycoside used for rate control in atrial fibrillation and symptomatic improvement in heart failure with reduced ejection fraction. NutriStack rates the supporting evidence as moderate. Common adult dosing is 0.0625–0.25 mg once daily; target serum level 0.5–0.9 ng/mL (as prescribed by your physician), though a prescriber sets the actual dose. This profile indexes 10 sources.
- Nausea, vomiting, and anorexia (early toxicity signs)
- Visual disturbances (yellow-green halos, classic toxicity sign)
- Cardiac arrhythmias (bradycardia, AV block, atrial tachycardia with block, bidirectional VT)
- Ventricular fibrillation4
- Hypertrophic obstructive cardiomyopathy (may worsen obstruction)
The bottom line
Evidence rating moderate. Most-documented uses: rate control in atrial fibrillation (especially at rest), reduces heart failure hospitalizations (dig trial), positive inotropic effect. 10 sources indexed (2015–2022), with 0 interaction records on file.
How it works, mechanistically.
Core mechanism
Inhibits the sodium-potassium ATPase (Na+/K+ pump) in cardiomyocytes, leading to increased intracellular sodium, which reduces calcium extrusion via the Na+/Ca2+ exchanger. The resulting increased intracellular calcium enhances contractility (positive inotrope). Also increases vagal tone and decreases sympathetic activity, slowing AV nodal conduction and heart rate. Centrally sensitizes baroreceptors, reducing neurohormonal activation in HF.
Dosing & protocol.
Can be taken with or without food; high-fiber meals and kaolin-pectin antacids can reduce absorption; primarily renally eliminated
Full safety detail.
Side effects
- Nausea, vomiting, and anorexia (early toxicity signs)
- Visual disturbances (yellow-green halos, classic toxicity sign)
- Cardiac arrhythmias (bradycardia, AV block, atrial tachycardia with block, bidirectional VT)
- Dizziness
- Confusion (especially in elderly)
- Gynecomastia (rare)
Sources, by evidence tier.
Numbered references. Citations throughout the page link here.
Meta-analyses & systematic reviews
5- 1Population pharmacokinetics of digoxin in elderly patients: A systematic reviewPMIDSalcedo-Mingoarranz ÁL, García-Díaz B, Barcia-Hernández E · Farmacia hospitalaria : organo oficial de expresion cientifica de la Sociedad Espanola de Farmacia Hospitalaria · 2022
Salcedo-Mingoarranz ÁL, García-Díaz B, Barcia-Hernández E. Population pharmacokinetics of digoxin in elderly patients: A systematic review. Farmacia hospitalaria : organo oficial de expresion cientifica de la Sociedad Espanola de Farmacia Hospitalaria. 2022
- 2Population Pharmacokinetic Studies of Digoxin in Adult Patients: A Systematic ReviewPMIDAbdel Jalil M, Abdullah N, Alsous M et al. · European journal of drug metabolism and pharmacokinetics · 2021
Abdel Jalil M, Abdullah N, Alsous M et al.. Population Pharmacokinetic Studies of Digoxin in Adult Patients: A Systematic Review. European journal of drug metabolism and pharmacokinetics. 2021
- 3A systematic review of population pharmacokinetic analyses of digoxin in the paediatric populationPMIDAbdel Jalil MH, Abdullah N, Alsous MM et al. · British journal of clinical pharmacology · 2020
Abdel Jalil MH, Abdullah N, Alsous MM et al.. A systematic review of population pharmacokinetic analyses of digoxin in the paediatric population. British journal of clinical pharmacology. 2020
- 4Systematic review and meta-analysis of mortality and digoxin use in atrial fibrillationPMIDQureshi W, O'Neal WT, Soliman EZ et al. · Cardiology journal · 2016
Qureshi W, O'Neal WT, Soliman EZ et al.. Systematic review and meta-analysis of mortality and digoxin use in atrial fibrillation. Cardiology journal. 2016
- 5Safety and efficacy of digoxin: systematic review and meta-analysis of observational and controlled trial dataPMIDZiff OJ, Lane DA, Samra M et al. · BMJ (Clinical research ed.) · 2015
Ziff OJ, Lane DA, Samra M et al.. Safety and efficacy of digoxin: systematic review and meta-analysis of observational and controlled trial data. BMJ (Clinical research ed.). 2015
Reference material
5- 6Digitalis Investigation Group. The effect of digoxin on mortality and morbidity in patients with heart failure (DIG trial). N Engl J Med. 1997.Source linkedPMID
- 7Rathore SS et al. Association of serum digoxin concentration and outcomes in patients with heart failure. JAMA. 2003.Source linkedPMID
- 8Chen SH et al. Comparative effectiveness of pharmacotherapy for heart failure with preserved ejection fraction: A systematic review and network meta-analysis. Diabetes Obes Metab. 2026.Source linkedPMID
- 9Patocka J, Nepovimova E, Wu W et al.. Digoxin: Pharmacology and toxicology-A review. Environmental toxicology and pharmacology. 2020Source linkedPMID
- 10Andrews P, Anseeuw K, Kotecha D et al.. Diagnosis and practical management of digoxin toxicity: a narrative review and consensus. European journal of emergency medicine : official journal of the European Society for Emergency Medicine. 2023Source linkedPMID
Common questions.
Quick answers about Digoxin, drawn from the data on this page.
What is Digoxin?
Digoxin is a cardiac glycoside used for rate control in atrial fibrillation and symptomatic improvement in heart failure with reduced ejection fraction. The DIG trial showed it reduces hospitalizations but not mortality in heart failure. It has a narrow therapeutic index, requiring careful dosing and monitoring.
What is Digoxin used for?
Commonly cited benefits of Digoxin include: Rate control in atrial fibrillation (especially at rest); Reduces heart failure hospitalizations (DIG trial); Positive inotropic effect; Reduces neurohormonal activation in heart failure. NutriStack rates the overall evidence as moderate.
What is a typical dose of Digoxin?
A typical adult dose of Digoxin is 0.0625–0.25 mg once daily; target serum level 0.5–0.9 ng/mL (as prescribed by your physician). The commonly recommended form is Oral tablet. These are general ranges, not personalized advice; confirm the right dose with a clinician.
What are the side effects of Digoxin?
Reported side effects include nausea, vomiting, and anorexia (early toxicity signs), visual disturbances (yellow-green halos, classic toxicity sign), cardiac arrhythmias (bradycardia, av block, atrial tachycardia with block, bidirectional vt), dizziness, confusion (especially in elderly), gynecomastia (rare). This is educational information; check with a healthcare professional before use.
How strong is the evidence for Digoxin?
NutriStack rates this as Moderate, meaning several aligned RCTs or one large RCT plus supporting reviews. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.
Use this with your stack
Digoxin in NutriStack.
Add it to your stack, see how it interacts with everything else you take, and get a Stack Score that updates the moment it does.