Digoxin tablets

Methyldigoxin is a derivative of digoxin in which the terminal hydroxyl group is replaced by a methoxyl group. Its positive inotropic effect is similar to that of digoxin but stronger, and its negative frequency effect and myocardial electrophysiological properties are similar to those of digoxin, while its molecular activity and drug lipophilicity are significantly enhanced, and it has the characteristics of good gastrointestinal absorption and rapid onset of action.

The chemical name of this product is: 3beta;-[[O-2,6-dideoxy-beta;-D-core-hexopyranosyl-(1rarr;4)-O-2,6-dideoxy-beta;-D-core-hexopyranosyl-(1rarr;4)-2,6-dideoxy-beta;-D-core-hexopyranosyloxy]-12beta;,14beta;-dihydroxy-5beta;-cardiosteroid-20(22)ene lactone. Molecular formula: C41H64O14 Molecular weight: 780.95

This product is white or off-white tablets.

Suitable for acute and chronic heart failure.

Oral administration: 0.2 mg at a time, twice a day. After 2-3 days, change to maintenance dose, 0.1 mg at a time, 1-2 times a day.

1. Common adverse reactions include: proarrhythmic effects, poor appetite or nausea, vomiting (stimulation of the medullary center), lower abdominal pain, abnormal weakness, and tenderness; 2. Rare reactions include: blurred vision or "color vision", such as yellow vision, green vision, diarrhea, and central nervous system reactions such as depression or confusion; 3. Rare reactions include: drowsiness, headache and rash, urticaria (allergic reaction); 4. Among the manifestations of digitalis poisoning, proarrhythmia is the most important, and the most common is ventricular premature beats, accounting for about 33% of proarrhythmic adverse reactions. The second is atrioventricular block, paroxysmal or accelerated junctional tachycardia, paroxysmal atrial tachycardia with atrioventricular block, ventricular tachycardia, sinus arrest, ventricular fibrillation, etc. Arrhythmias in children

1. Combined with calcium injection; 2. Poisoning by any digitalis preparation; 3. Ventricular tachycardia, ventricular fibrillation; 4. Obstructive hypertrophic cardiomyopathy (can still be considered if accompanied by systolic dysfunction or atrial fibrillation); 5. Preexcitation syndrome with atrial fibrillation or flutter.

Precautions for children: The tolerance of newborns to this product is uncertain, and their renal clearance is reduced; premature infants and immature infants are sensitive to this product, and the dosage should be reduced according to their degree of immaturity. In terms of weight or body surface area, the dosage for infants over 1 month old is slightly larger than that for adults. Precautions for pregnancy and lactation: This product can pass through the placenta, so the maternal dosage may be appropriately increased in the late pregnancy and reduced 6 weeks after delivery. This product can be excreted into breast milk, and lactating women must weigh the pros and cons when using it. Precautions for the elderly: Not yet clear.

1. When used together with amphotericin B, corticosteroids or potassium-losing diuretics such as bumetanide (the product is buturamine) and ethacrynic acid (ethacrynic acid), it can cause hypokalemia and lead to digitalis poisoning; 2. When used together with antacids (especially magnesium trisilicate) or antidiarrheal adsorbents such as white clay, pectin, colestyramine (cholestyramine) and other anion exchange resins, sulfasalazine or neomycin, and aminosalicylic acid, it can inhibit the absorption of digitalis cardiac glycosides and lead to a weakening of the effect of cardiac glycosides; 3. When used together with antiarrhythmic drugs, calcium salt injections , cocaine, pancuronium bromide (PancuroniumBromide, Pankelong, Bahuolang), rauwolfia ine, succinylcholine (Scoline; SuxamethoniumChloride) or adrenergic drugs when used together, arrhythmias may occur due to additive effects; 4. Patients with severe or complete atrioventricular block and normal blood potassium should not use potassium salts at the same time with digitalis, but when thiazide diuretics are used with this product, potassium salts are often required to prevent hypokalemia; 5. The use of beta-receptor blockers with this product may cause severe bradycardia due to atrioventricular block, which should be taken seriously. But it does not rule out the use of beta-blockers for supraventricular tachyarrhythmias where digitalis cannot control the ventricular rate; 6. When used together with quinidine, the blood concentration of this product can be increased by about one-fold. The degree of increase is related to the dosage of quinidine and can even reach toxic concentrations. Even if digoxin is discontinued, its blood concentration continues to rise. This is because quinidine replaces digoxin from tissue binding and reduces its distribution volume. When the two drugs are used together, the dosage of digoxin should be reduced by 1/2-1/3; 7 When used together with verapamil, diltiazem, and amiodarone, the blood concentration of digoxin can be increased due to the reduction of the renal and systemic clearance rate of digoxin, which can cause severe bradycardia; 8 Spironolactone can prolong the half-life of this product, and the dose or dosing interval needs to be adjusted, and the blood concentration of this product should be followed up and monitored; 9 Angiotensin converting enzyme inhibitors and their receptor antagonists can increase the blood concentration of this product; 10 EdrophoniumChloride (Tensilon) and this product can cause obvious bradycardia when used together; 11 Indomethacin (Indome 12. When used with heparin, this product may partially offset the anticoagulant effect of heparin, so the dosage of heparin needs to be adjusted; 13. When using magnesium sulfate intravenously during digitalization, extreme caution should be exercised, especially when calcium salts are also injected intravenously, as heart block may occur; 14. Erythromycin can increase the absorption of this product in the gastrointestinal tract by changing the gastrointestinal flora; 15. Metoclopramide (Maxolon) reduces the bioavailability of digoxin by about 25% due to promoting intestinal motility. Propane increases the bioavailability of digoxin by about 25% due to inhibiting intestinal peristalsis.

Store in a dark, airtight, cool and dry place.

0.1mg

24 months