Lanoxin Tablets Injection

Lanoxin generic name is Digoxin. Digoxin which Lanoxin Tablets Injection used in its formulation is considered as a prototype cardiac glycoside, combine a steroid nucleus with an unsturated five membered lactone ring at the 17th position. And a series of sugar linked to carbon 3 of nucleus. Which contain 3 molecules of digitoxse linked to digitoxigenin. Meanwhile, Digoxin obtained from the leaves of Digitalis lanata. Furthermore, It use to make heart function more effective.

Lanoxin Tablets Indications

Lanoxin Tablets Injection uses for the management of chronic cardiac failure conditions. Where the dominant problem is systolic dysfunction. Its therapeutic benefit is those patients with ventricular dilatation. Lanoxin Tablets or Injection specifically indicated where cardiac failure is accompanied by atrial fibrillation. While Lanoxin alsoindicated in the management of certain supraventricular arrhythmias, particularly chronic atrial and fibrillation.

Lanoxin Tablets Dosage Administration

The Lanoxin Dose for each patients has to be tailored individually according to age, lean body weight and renal function. However, suggested Lanoxin doses are intended only as an initial guide. Meanwhile, difference in bio availability between Lanoxin Injection and Lanoxin Tablet oral formulations must considered when changing from one to another. For example if patients are switched from Lanoxin oral to the Lanoxin intravenous formulation the Lanoxin dosage should be reduced by approximately 33.

Lanoxin 250 MG, MCG Tablet For Adults And Children (over 10 years)

For Lanoxin Oral Use

Adults With Chronic Cardiac Failure In The Absence Of Supraventricular Arrhythmis

No loading Lanoxin dose is required. The usual daily Lanoxin dose is 125 to 250 micrograms (0.125 to 0.25 mg) for patients with normal renal function. On the other hand, a lower Lanoxin dose of 62.5 micrograms (0.0625mg) should considered in the elderly.

For The Management Of Atrial Fibrillation Or Flutter.

Rapid oral loading

If medically appropriate, rapid digitalisation may be achieved in a number of ways, such as the following:

It recommended to use Lenoxin 750 to 1500 micrograms (0.75 to 1.5 mg) in a single dose. Furthermore, where there is less urgency, or greater risk of toxicity. The oral loading dose should given in divided doses 6 hours apart and assessing clinical response before giving each additional dose.

Slow oral loading

Meanwhile, In some patients with mild heart failure, the digitalisation may achieved more slowly with Lanoxin doses of 250 to 750 micrograms (0.25 to 0.75 mg) daily for one week. with following by an appropriate maintenance Lenoxin dose. Generally the clinical response must seen within one week. However, the choice between slow and rapid oral loading depends on the clinical state of the patients and the urgency of the condition.

Lanoxin 0.25 MG/1 ML Solution For Injection

For Intravenous Use

Parenteral loading

For use in patients who have not been cardiac glycosides within the preceding two weeks. The loading of parenteral Lanoxin 500 to 1000 micrograms (0.5 to 1.0 mg) depending on age, lean body weight and renal function. The loading lanoxin dose should administered in divided with approximately half of the total dose given as the first dose. And further total Lenoxin dose used in intervals of 4 to 8 hours. An assessment of clinical response should performed before giving each additional dose. Each dose should given by intravenous infusion.

Maintenance Dose (all formulations)

The maintenance lanoxin dosage should be based upon the percentage of the peak body stores lost each day through elimination.

In practical studies, most patients with heart failure will maintained on 125 to 250 micrograms (0.125 to 0.25 mg ) Lanoxin daily. However in those who show increase sensitivity to the adverse effect of a dose of 62.5 micrograms (0.0625 mg ) daily or less may suffice. Conversely, some patients may require a higher dose

Neonates , infants and children up to 10 years of age (if cardiac glycosides have not been given in preceding two weeks).

If cardiac glycoside have given in the two weeks preceding commencement of digoxin therapy. It should anticipated that optimum loading doses of digxoin will less than those recommended below. Meanwhile, in the newly born babies, renal clearance of Lonaxin diminished and suitable dose reductions must observed, over and above general dosage instructions. Beyond the immediate newborn period. Generally require proportionally increased doses than adults on the basis of body weight or body surface area. Children over 10 years of age require adult dosage in proportion to their body weight.

Parenterla Loading

The parenteral loading dose in the above groups should be administered in accordance with the following schedule:

Preterm neonates less than 1.5 kg 20 micrograms/kg over 24 hours.

Preterm 1.5 kg to 2.5 kg 30 micrograms/kg over 24 hours.

Term neonates to 2 years 35 micrograms /kg over 24 hours.

2 to 5 years 35 micrograms / kg over 24 hours.

5 to 10 years 25 micrograms/ kg over 24 hours.

The loading Lanoxin dose should administered in divided doses with approximately half the total dose given as the first dose. And further lenoxin Tablets Injection doses of the total Lonaxin Tablets Injections dose may use at intervals of 4 to 8 given by i.v infusion Oral loading dose

This should administered in accordance with the following schedule;

Preterm neonates less than 1.5 kg 25 micrograms/kg per 24 hours .

Preetem neonates 1.5 kg to 2.5 kg 30 micrograms /kg per 24 hours.

Term neonates to 2 years 45 micrograms /kg per 24 hours.

2 to 5 years 35 micrograms /kg per 24 hours.

5 to 10 years 25 micrograms /kg per 24 hours.

The loading dose should administered in divided doses with approximately half the total dose given as the first dose. And further fractions of the total dose given at intervals of 4 to 8 hours, assessing clinical response before giving each additional dose.

Maintenance Dose

The maintenance dose should administered in accordance with the following schedule ;

Preterm neonates: daily dose 20 of 24 hours loading dose. Term neonate and children up to 10 years;

daily dose =25/24 hours loading dose . Meanwhile, these Lonaxin Tablets Injections dosage schedule provide just guidelines and careful observation and monitoring of serum Lanoxin levels should used as a basis for adjustment of dosage in these oaediatric patient groups.

Lanoxin Dose For Elderly

Meanwhile, tendency to impaired renal function and low lean body mass in the elderly patients the pharmacokinetics of Lanoxin. Such that high serum Lanoxin levels and associated toxicity can occur quite readily. Unless doses lower than those in non elderly patients used. Furthermore, the serum Laxonin Injection Tablet levels must checked regularly and hypokalaemia must avoided.

Renal Impairment

A reduction in both initial and maintenance doses should considered.

Lanoxin Contraindications

Lanoxin Tablets Injection contraindicated in patients known to be hypersensitive to digoxin, other digitalis glycosides, or to any component of the preparation. In intermittent complete heart block or second degree atrioventricular block. Especially if there is a history of Stokes Adams attacks in any patient. Furthermore, Lanoxin contraindicated in arrhythmias caused by cardiac glycoside intoxication. On the other hand, It also contraindicated in supraventricular arrhythmias associated with an accessory atrioventricular characteristics of the accessory pathway. And any possible deleterious effect of digoxin on these characteristics has been evaluated. If an accessory pathway known or suspected to present. And there is no history of previous supraventricular arrhythmias, Lanoxin similarly contraindicated. Lanoxin contraindicated in ventricular tachycardia or ventricular fibrillation. The drug also contraindicated in hypertrophic obstructive cardiomyopathy, unless there is concomitant atria fibrillation and heart failure. But even then caution should be exercised if Digoxin is to be used.

Lanoxin Medicine Warnings And Precautions

Arrhytjmias may be precipitated by digoxin toxicity, some of which can resemble arrhythmias for which the lanoxin drug could be advised. In some cases of sinoatrial disorder (i.e.Sick Sinus Syndrome) Lanoxin Medicine may cause or exacerbate sinus bradycardia or cause sinoatrial block. The administration of Lanoxin Drug in the period immediately following myocardial infarction is not contraindicated. However, the use of inotropic drugs in some patients in this setting may result in undesirable increase in myocardial oxygen demand. And ischaemia or some retrospective following studies have suggested Lanoxin Medicine to be associated with an increased risk of death. Treatment with Lanoxin Durg should generally avoided in patients with heart failure associated with cardiac amyloidosis.

However, if alternative treatment with other drug not appropriate, digoxin medicine can used with caution to control the ventripitate vasoconstriction. Therefore should avoided in patients with myocarditis. Furthermore, the patients of beri beri heart disease may fail to respond with the use to Lanoxin. If the underlying thiamine deficiency not treated concomitantly. There also some published information indicating that digoxin Drug may inhibit the uptake of thiamine in myocytes in beri beri heart disease. Lanoxin should not used in constrictive pericarditis unless it used to control the ventricular rate in atrial fibrillation or to improve systolic dysfunction. The drug improves exercise tolerance in patients with impaired left ventricular systolic dysfuction. And normal sinus rhthm. This may or may not associated with an improved haemodynamic profile.

Lanoxin 250 Micrograms Tablets

Patients with malabsorption syndrome or gastro intestinal reconstructions may require larger doses of Digoxin Medicine.

Lactose

Patients with hereditary problems of fructose or galactose intolerance the lapp lactase deficiency. Or glucoses galactose malabsorption or sucrose isomaltase insufficiency should not take the medicine.

Lanoxin (Digoxin) In Pregnancy

The use of Laxonin (Digoxin) in pregnancy not contraindicated. Although the Digoxin Dosage may less predictable in pregnant than in non-pregnant women with some requiring an increased dosage of Lanoxin during Pregnancy. Adverse foetal effects have reported in mothers with digitalis toxicity. Although Digoxin excerted in breast milk the quantities minute and breast feeding not contraindicated.

Lanoxin (Digoxin) Side Effects

Blood And Lymphatic System Disorders

Very Rare: Thrombocytopaenia

Metabolism And Nutrition Disorders

Very Rare: Anorexia

Psychiatric Disorders

Uncommon: Depression

Very Rare: Psychosis, Apathy, Confusion

Nervous System Disorders

Common: CNS Disturbances, Dizziness

Very Rare: Headache

Eye Disorders

Common: Visual Disturbances, Blurred or yellow vision

Cardiac Disorders

Commons: Arrhythmia, Conduction disturbances, Bigeminy, trigeminy, PR prolongation, Sinus bradycardia

Very Rare: Supraventricular tachyarrhythmia, atrial tachycardia, junctional tachycardia, venticular arrhythmia, venticular premature contaction, ST Segment depression

Gastro Intestinal Disorder

Commons: Nausea, vomiting, diarrhoea

Very Rare: Intestinal ischaemia, intestinal necrosis

Skin And Subcutaneous Tissue Disorders

Commons: Skin Rashes of urticaria or scarlatiniform character may find by pronounced eosinophilia.

Reproductive System And Breast Disorders

Very Rare: Gynaecomastia can occur with long term administration.

General Disorders And Administration Site Conditions

Very Rare: Fatigue, malaise, weakness

Lanoxin (Digoxin) Overdose Symptoms And Treatment

Lanoxin (Digoxin) Overdose symptoms and signs become more frequent with levels above 2.0 nanograms/ml. Although there is considerable inter individual variation.

Adults

In adults without heart disease, clinical observations suggests that Digoxin Overdose of 10 mg to 15 mg was the dose resulting in death of half of the patients. Meanwhile, Cardiac manifestations can be the most frequent and serious sign of both acute and chronic Lanoxin Tablets Injection toxicity. However, Peak cardiac side effects generally occur 3 to 6 hours following Lanoxin overdosage. And may persist for the ensuling 24 hours or longer. Lanoxin toxicity may reslut in almost any type of arrhythmia. Furthermore studies shows, some multiple rhythm disturbances and disorders in the same patient are common.

These include paroxysmal atrial tachycardis with varibale atrioventricular block , accelerated hunctional rhythm, slow atrial fibrilltion (with very little variation in the ventricular rate) and bi directional ventricular tachycardia. Premature ventricular contractions are often the earliest and most common arrhythmia. Bigeminy or trigeminy also occur frequently. Sinus bradycardia and other bradyarrhythmias are very common. First , second and the third degree heart blocks and AV dissociation are also common. Early toxicity may only manifested by prolongation of the PR interval. Ventricular tachycardia may also be a manifestation of toxicity. Furthermore, Cardiac arrest from asystole or ventricular fibrillation due to digoxin toxicity also usually fatal. Hypokalaemia may contribute to toxicity.

Children

In children aged 1 to 3 years without the heart disease the clinical studies shows that an overdose of Lanoxin of 6 to 10 mg was the dose resulting in death in half of the patients. Most manifestations of toxicity in children occur during or shortly after the loading phase with Digoxin Medicine.

Cardiac Manifestations

The same arrhythmias or combination of arrhythmias that occur in adults can occur in children. Sinus tachycardia, supraventricular tachycardia, and rapid atrial fibrillation seen less frequently in the paediatric population. Paediatric patients more likely to prescient with an AV conduction disturbance or a sinus bradycardia. ventricular ectopy less common. However in massive overdose, ventricular ectopy, ventricular tachycardia and ventricular fibrillition have reported. Any arrhythmia ralteration in cardiac conduction that develops in a child taking LANOXIN should assumed to caused by digoxin until further evaluation proves otherwise. The frequent extracardiac manifestations similar to those seen in adults gastrointestinal, CNS and visual. However, nausea and vomiting not frequent in infants and small children .

Treatment

Meanwhile, the patients with massive digitalis ingestion should receive large dose of activated charcoal to prevent absorption. And also bind LANOXIN in the gut during enteroenteric recirculation. Hypokalaemia should corrected. In cases where a large amount of LANXOIN has ingested, hyperkalaemia may present due to release of potassium from skeletal muscle. Before administering potassium in LANOXIN overdose the serum potassium level must known. If more than 25 mg of LANOXIN ingested by an adult without heart disease. Moreover, death or progressive toxicity responsive only to digoxin binding Fab antibody fragments may resulted. If more than Digoxin 10 MG ingested by a child aged 1 to 3 years without heart disease , the outcome uniformly fatal when Fab fragments treatment not given .

Lanoxin (Digoxin) Tablets Injection Storage Instructions

Most importantly, store Lanoxin (Digoxin) Tablets Injection below 25 C temperatures. On the other hand, also protect the drug from heat and sun light. Furthermore, Do not freeze the medicine. In addition, you must remember to keep all your medical products out of the reach of your children at home.

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Lanoxin (Digoxin) Tablets, Injection

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