These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.
Lanoxin [posted 8/14/98]
Question: I’m a 2nd year register nurse and I work in a hostel for the aged and
disabled. A lot of the elderly are on various levels of lanoxin. I was curious
as to how often blood tests to check the lanoxin levels are to be done? Is it
like lithium where it gets routinely checked every so often?
Answer: It should be especially if there is any change in renal function since this would increase the drug levels. I usually check it every 6 months.
Lanoxin and Diabetes [posted 8/14/98]
Question: My father (65 years old) has been taking Lanoxin (250 mcg once per day) since the beginning of 1997 to control atrial fibrillation and by about the middle of March he began to experience tingling in hands and feet, which by December 1997 had extended to his full body. In August after a glucose tolerance test, he was diagnosed as having type 2 diabetes which is diet controllable. Is there any possibility that the tingling in the skin and so on could be Lanoxin related or Diabetes related especially when considering the speed that it has spread? Is there any possibility that the Diabetes could be Lanoxin (e.g. steroid) induced? My father’s fasting glucose reading in the morning on a glucometer is around 4.9 mmol/L each morning. The only other medication my father is taking routinely is Cardiprin 100 mg – 1 pill every second day taken over many years following a cardiac infarction in 1981. He has decided to experiment by reducing the Lanoxin dosage to 125 mcg per day from the beginning of December and from January 1998 to 62.5 mcg per day, so far without any further experience of atrial fibrillation. This has so far not produced any noticeable reduction in the tingling.
Other notes: On 1st of August his lipid profile was: cholesterol 6.1 mmol/L, triglycerides 4.9 mmol/L, HDL 0.4 mmol/L the LDL calculation was invalidated by the elevated triglyceride level. HDLC was 10.2. As a result, a glucose tolerance test was taken resulting in the diagnosis of diabetes. Blood glucose in this test was: fasting 6.1 mmol/L + 1 hour 12.2 mmol/L + 2 hours: 11.8 mmol/L
A further cholesterol check was done on October 6th following a reduction in sugar intake giving a lipid profile of:
cholesterol 4.2 mmol/L, triglycerides 2.3 mmol/L, HDL 0.6 mmol/L the LDL: 2.6 mmol/L HDLC was 7. Fasting glucose of 5.4 mmol/L.
My father is concerned about the rapid spread of tingling and wonders if he is being poisoned by the Lanoxin and whether the Lanoxin produce the diabetes? Can you suggest any other references that we can use in our research?
Answer: Digoxin is a good heart drug, but can be very toxic if not watched closely. Your father can get a blood level performed which will give him an idea of how high his dosage is. It would depend a lot on his weight, renal function and some other factors. In general, large men need .25 and middle size men can sometimes take .125 mg. The digoxin would not have any effect on the sugar level.
Lanoxin and Cirrhosis [posted 7/21/98]
Question: My mother-in-law has taken Lanoxin for 12 years. She has CHF and now has been found (at 78 years of age) to have cirrhosis of the liver. She only goes to doctors for acute problems, and never has a well-checkup, but has had problems in recent years. Enough problems that we would think that a LFT would be done and elevation noted. Could the Lanoxin have contributed/caused the cirrhosis?
Answer: The lanoxin probably didn’t affect the liver. However, CHF can lead to cirrhosis if there is excessive pressure on the right side of the heart leading to the liver.
Lanoxin / digoxin
Question: I am a 70 year old male. I have been on Lanoxin for the past 5
years. About 4 months ago I developed a painful left breast behind the
nipple. Recently it seems to be developing into gynecomastia. I have
consulted a surgeon and he says Lanoxin is implicated. He suggested I
discontinue the Lanoxin.
I made an appointment with my cardiologist and he says this syndrome is
very rare, but has taken me off the Lanoxin. I was on the Lanoxin for an
irregular heartbeat.
I would appreciate any information on this matter.
Answer: Digoxin has a similar ring structure to estrogen. Both possess the same A ring (one of the steroid rings). Consequently, about 10-15% of men will develop breast development.
Lanoxin
Question: I am currently taking 0.125 mg of Lanoxin once a day. I have been taking this dosage for more than 5 years. I believe that I also have mild gynecomastia and have recently discovered that this is a Lanoxin side effect. I am a teenager and usally this condition would just be attributed to fluctating hormone levels, but it has been present for 5 years. I am not overwieght and thus I am begining to conclude that Lanoxin is the cause. What I am wondering is whether or not this will disappear after treatment with Lanoxin is discontinued.
Answer: Digoxin is a known cause of gynecomastia . This is probably due to the similarity of structure between digoxin and estrogen (they have the same steroid A ring). Stopping the lanoxin may help. However, sometimes this is irreversible.
Lanoxicap
Question: I was released from taking Lanoxicap 0.2 in December of 1996. I am also a weight lifter. I have noticed a major decrease in my strength level since coming off of the drug. I was curious if Lanoxicap would have had an anabolic effect on me while I was taking it. I was on Lanoxicap for approximately 5 years.
Answer: Lanoxin has a steroid ring as part of its structure. It definitely has a small effect like estrogen and can be responsible for breast development in some patients. Consequently, I would not be surprised to see an effect on muscle strength and development, although I’ve never seen this researched.
Lanoxin and Gynecomastia
Question: I would like information regarding the likelihood of Lanoxin causing gynecomastia.
Answer: Lanoxin has similar structural characteristics to steroid hormones. This can produce
estrogen effects in people taking the drug. It is not clear as to why one patient gets estrogen
effects and another does not. Gynecomastia is only noted in men. Breast enlargement is less
noted in women, but soreness often occurs. About 10% of men experience gynecomastia.
Lanoxin and memory loss
Question: I have been taking Lanoxin (0.25 mg each morning) for several months to regulate occasional arrhythmia. I have not noticed any side-effects, but I was recently told that lanoxin can contribute to memory loss.
Answer: Digoxin usually has nothing to do with memory loss unless the drug is given in high or toxic levels. Then the memory problem is usually reversible. See what your level is and stay on the lower side unless you continue to have arrhythmias.
Lanoxin
Question: My mother is taking a number of different medications and I am concerned about interactions and side-effects. Can someone provide me with information on these drugs and possible problems associated with them? Also, she has recently been sleeping more and seems depressed since starting a new drug, Lanoxin. She also takes Coumadin and Diabeta and Premarin.
Answer: Lanoxin is the brand name of the drug digoxin. Your mother is probably taking Lanoxin because she has developed what is called atrial fibrillation, which is a rapid fluttering of the upper chamber of the heart. This is a dangerous
condition because the blood in the atrium is not moving rapidly through the heart and thus may form tiny clots. These clots can lodge in the lungs, brain or other parts of the body and cause significant damage. Your mother has been prescribed Coumadin (warfarin) to help prevent such clots from forming.
Sleepiness and depression can indeed be caused by Lanoxin. Such side-effects can be an expected result of taking Lanoxin, but they can also be signs of dangerously high levels of the drug. It is therefore very important that you tell your mother’s doctor about these symptoms at once if you have not done so already.
Lanoxin is not likely to interact with any of the medications you list with the possible exception of DiaBeta (glyburide). Your mother is taking this medication in order to lower her blood sugar level. Drugs similar to DiaBeta have been known to increase blood levels of Lanoxin. Since your mother apparently began taking Lanoxin after she was already taking DiaBeta this is not likely to be a problem. It is important to be sure her doctor knows she is taking DiaBeta if he/she does not know this already.
Lanoxin, Coumadin and DiaBeta are all potent drugs which can be very beneficial but require careful monitoring. Although used to treat heart rhythm problems, too much Lanoxin can ironically cause such problems as well. If her pulse falls below 60 her doctor should be notified.
Since Coumadin works by preventing blood from clotting, too much of this drug may lead to uncontrolled bleeding. Such bleeding often happens in the stomach or intestine. Thus she should be on the lookout for tarry stool which might indicate such bleeding.
An excessive dose of DiaBeta might cause your mother’s blood sugar level to drop too low. This might cause weakness, sweating, tremor or rapid heart beat.
Her doctor should be regularly performing lab work to determine the blood level of Lanoxin and running other tests to insure that the Coumadin and DiaBeta are working properly.
There are several useful articles on stroke, atrial fibrillation and diabetes which can be found in the “Heart and Stroke Guide” of the “Medical Reference and Study” area of the Drug Infonet site.
