Order Digoxin tablets online from a USA pharmacy

Product Name	Digoxin
Dosage	0.0625 mg, 0.125 mg, 0.25 mg
Active Ingredient	Digoxin
Form	Oral tablets / oral solution / injection
Description	Used to help treat heart failure symptoms and to control ventricular rate in atrial fibrillation/atrial flutter. Narrow therapeutic index—requires careful dosing and monitoring.
Prescription Requirement (USA)	Prescription required

Digoxin is a prescription cardiac medication widely used in the United States to help manage heart failure symptoms and to control heart rate in atrial fibrillation and atrial flutter. It belongs to a class of medicines called cardiac glycosides, originally derived from the foxglove plant (Digitalis lanata). In the U.S., digoxin has been part of cardiovascular care for decades, and modern practice emphasizes careful patient selection, moderate dosing, and regular monitoring to maximize benefit and reduce risks.

American pharmacies dispense digoxin in several strengths and forms, with the most common tablets being 0.0625 mg, 0.125 mg, and 0.25 mg. There is also an oral solution (useful for those who have difficulty swallowing or require very precise doses) and an injectable form for hospital use. Because digoxin has a narrow therapeutic index—meaning the effective dose is close to the dose that can cause toxicity—U.S. clinicians typically tailor dosing to the individual and monitor serum levels, kidney function, and electrolytes. When appropriately prescribed and monitored, digoxin can improve exercise tolerance, reduce symptoms such as fatigue and dyspnea in heart failure, and help achieve target resting heart rates in atrial fibrillation.

Digoxin cost in the USA

Digoxin is available as a generic medication in the U.S., which helps keep costs affordable for many patients. Actual out-of-pocket expense varies based on insurance coverage, pharmacy pricing, and discount programs. In general, generic digoxin tablets are inexpensive compared to many newer cardiovascular drugs, and many retail pharmacies offer competitive pricing on 30- or 90-day supplies.

While exact prices fluctuate by state and pharmacy chain, a typical 30-day supply of generic digoxin 0.125 mg or 0.25 mg tablets can be relatively low-cost, particularly with prescription discount programs used throughout the United States. For the most accurate cost in your area, check your local pharmacy or use a reputable U.S. medication-pricing tool. Mail-order options through American pharmacies may further reduce the overall cost for stable, long-term therapy.

If you are insured, your copay will depend on your plan’s tier placement for generic cardiac medications. Medicare Part D plans often include digoxin on formularies, but deductibles and copays differ by plan and state. Patients without insurance may find significant savings through popular U.S. discount cards or pharmacy membership programs, which are widely accepted nationwide.

Because digoxin requires periodic lab monitoring for safety and effectiveness, be sure to factor in the cost of laboratory tests (serum digoxin level, basic metabolic panel, and sometimes thyroid function tests) and clinical visits when budgeting for therapy. Many health systems and clinics across the U.S. offer bundled pricing or sliding-scale services to keep ongoing monitoring accessible.

Where can I buy digoxin in the USA?

In the United States, digoxin is a prescription medication. To obtain it legally and safely, you will need a valid prescription from a licensed U.S. healthcare provider. Once you have your prescription, you can fill it at a neighborhood retail pharmacy, a hospital outpatient pharmacy, or a legitimate U.S.-based online/mail-order pharmacy that ships directly to your home.

Reputable American pharmacies provide transparent pricing, clear counseling about dosing and interactions, and access to pharmacists who can answer questions about your regimen. If you are switching pharmacies, ensure your current medication list and recent lab results are available so your new pharmacist can help verify dosing and monitor for potential interactions with your other prescriptions or supplements.

For convenience, many people in the USA choose online pharmacy services to manage long-term cardiovascular therapy. These services commonly offer automatic refill reminders, 90-day supplies, and discreet home delivery. Always choose a U.S. pharmacy that is licensed in your state, uses secure payment methods, and offers customer support from certified pharmacists.

Digoxin in the USA

Getting digoxin in the United States is straightforward with a prescription. After your clinician confirms that digoxin is appropriate for your condition—most commonly symptomatic heart failure with reduced ejection fraction or rate control in atrial fibrillation—your dose is carefully selected based on age, kidney function, body mass, and concomitant medications. In routine U.S. practice, many adults start at 0.125 mg once daily, with lower doses considered for older adults, those with low body weight, or patients with chronic kidney disease. Your care team may order a serum digoxin level after steady state is reached to fine-tune the dose.

What is digoxin?

Digoxin is a positive inotrope (it strengthens the force of cardiac contraction) and a negative chronotrope (it can slow the heart rate). Its primary mechanism of action is the inhibition of the sodium-potassium ATPase pump in cardiomyocytes. This inhibition increases intracellular sodium, which in turn promotes calcium influx via the sodium-calcium exchanger. The higher intracellular calcium improves myocardial contractility. Digoxin also enhances vagal tone, contributing to slowed conduction through the atrioventricular (AV) node—useful for controlling ventricular response in atrial fibrillation and atrial flutter.

In contemporary U.S. guidelines, digoxin is not typically the first-line treatment for heart failure but may be considered for patients with persistent symptoms despite standard therapy (such as ACE inhibitors, ARBs, ARNIs, beta-blockers, mineralocorticoid receptor antagonists, and SGLT2 inhibitors). In atrial fibrillation, it does not convert the rhythm back to normal (sinus rhythm), but it can lower resting heart rate, especially in sedentary individuals or in those with concomitant heart failure where other agents are not tolerated or insufficient.

Modern U.S. usage emphasizes thoughtful patient selection, a conservative dose, and regular monitoring to avoid toxicity. Careful attention to kidney function and electrolytes (especially potassium, magnesium, and calcium) is crucial, because imbalances can heighten the risk of adverse cardiac effects.

Digoxin in heart failure management

In heart failure with reduced ejection fraction (HFrEF), digoxin may improve symptoms such as fatigue and dyspnea by enhancing cardiac contractility and neurohormonal modulation. While it has not demonstrated a mortality benefit in large trials, it may reduce heart failure hospitalizations when appropriately dosed and monitored. In U.S. practice, clinicians often consider digoxin for patients with persistent symptoms despite guideline-directed medical therapy or for those with atrial fibrillation where achieving rate control is challenging.

Because digoxin’s therapeutic window is narrow, American clinicians frequently aim for lower serum concentrations (for example, 0.5–0.9 ng/mL for heart failure symptom management) and avoid levels above 1.2 ng/mL in most situations. This approach balances the potential benefits with a reduced risk of toxicity, which includes arrhythmias, gastrointestinal upset, neuro-visual disturbances, and, rarely, life-threatening events.

Close outpatient follow-up is standard. After any dose change, clinicians may order a level once steady state has been reached (typically 5–7 days, longer if renal function is impaired), drawn at least 6–8 hours after the last dose (ideally just before the next dose) to avoid falsely elevated values.

Why digoxin is sometimes chosen in heart failure

Digoxin can be particularly helpful in patients who remain symptomatic despite optimal background therapy or in those who also have atrial fibrillation with a rapid ventricular response. It may be selected when further uptitration of beta-blockers is limited by low blood pressure or when non-dihydropyridine calcium channel blockers are contraindicated (for example, in HFrEF). In these scenarios, digoxin provides incremental symptom relief and heart rate control, provided appropriate monitoring is in place.

Digoxin for atrial fibrillation and atrial flutter

In atrial fibrillation (AF) and atrial flutter, digoxin is used to help control ventricular rate, primarily by slowing conduction through the AV node via enhanced vagal tone. It is most effective at controlling resting heart rate and is less effective during exertion or in states of high sympathetic tone. For this reason, in U.S. practice, digoxin is often combined with other rate-controlling agents (e.g., beta-blockers) or reserved for patients who are relatively sedentary, have heart failure, or cannot tolerate first-line therapies.

Digoxin does not restore normal sinus rhythm; it is a rate-control medication. In AF due to hyperadrenergic states or during physical activity, additional or alternative agents are usually needed. Clinicians also consider comorbidities, concomitant medications, and renal function when deciding if digoxin is a suitable part of the rate-control strategy.

When is digoxin appropriate for rate control?

Digoxin may be appropriate for rate control in the following situations:

• in patients with atrial fibrillation and heart failure with reduced ejection fraction
• when beta-blockers or non-dihydropyridine calcium channel blockers are contraindicated, not tolerated, or insufficient alone
• in relatively sedentary patients where resting rate control is the primary goal

Available dosage forms and strengths (USA)

U.S.-available formulations include:

• tablets: commonly 0.0625 mg, 0.125 mg, and 0.25 mg
• oral solution: useful for patients with swallowing difficulties or for precise pediatric dosing
• injection: used in hospital settings for certain acute indications

Brand names previously or currently used in the USA include Lanoxin and Digox, among others. Regardless of brand, generic digoxin products in the U.S. are subject to FDA standards for quality and bioequivalence. Because small differences can matter for narrow-therapeutic-index drugs, many clinicians recommend staying with the same product when possible and rechecking levels if a product switch occurs.

Onset of action, pharmacokinetics, and renal dosing

With oral dosing, digoxin’s onset of action occurs within 30 minutes to 2 hours, and peak effect may take 2–6 hours. The elimination half-life in individuals with normal kidney function is roughly 36–48 hours, but it is substantially prolonged in renal impairment. Because digoxin is primarily cleared renally, U.S. dosing guidelines typically call for lower initial and maintenance doses in patients with reduced creatinine clearance, the elderly, or those with low lean body mass. Achieving steady state can take about a week in those with normal renal function and longer when kidney function is impaired.

Electrolyte abnormalities—especially hypokalemia, hypomagnesemia, and hypercalcemia—can predispose to digoxin toxicity. For patients on diuretics or those with fluctuating kidney function, closer surveillance is recommended. Thyroid status can also influence digoxin’s pharmacodynamics: hypothyroidism can increase sensitivity, while hyperthyroidism may reduce effect at a given level.

Mechanism of action

Digoxin inhibits the Na+/K+ ATPase pump in cardiomyocytes, increasing intracellular sodium. This shift favors calcium entry via the sodium-calcium exchanger, enhancing contractility (positive inotropy). Additionally, it augments parasympathetic (vagal) tone, slowing AV nodal conduction and helping control ventricular rate in AF. These dual actions explain its role in both heart failure symptom relief and rate control in select arrhythmias.

Safety

Millions of patients have received digoxin worldwide, and it remains an important option in certain cardiovascular scenarios. In the United States, safe use hinges on proper patient selection, conservative dosing, level monitoring when indicated, and vigilance for drug–drug and drug–electrolyte interactions. Common dose-related side effects include gastrointestinal upset (nausea, vomiting, reduced appetite), fatigue, dizziness, and headache. Visual changes (blurry or yellow-tinged vision), confusion, and cardiac arrhythmias are concerning for toxicity and warrant immediate medical evaluation. The risk of adverse events is higher with elevated serum levels, impaired renal function, and electrolyte abnormalities.

Adult dosing guidelines

Typical U.S. maintenance dosing for adults often starts at 0.125 mg orally once daily. Lower doses (such as 0.0625 mg daily or every other day) may be appropriate for older adults, those with impaired kidney function, or individuals with low body mass. Some patients—especially those with normal renal function and good tolerance—may require 0.25 mg once daily for rate control, but the prevailing trend in U.S. practice is to use the lowest effective dose and aim for lower serum levels in heart failure.

Initial loading doses (digitalization) may be used for certain arrhythmia indications in inpatient settings. Loading must be individualized and supervised by a clinician who can monitor response and ECG parameters. Many outpatients do not require loading, particularly when digoxin is added for symptom relief in chronic heart failure.

Loading dose and maintenance dosing

Loading doses are considered when a faster therapeutic effect is needed, often in the hospital. A common approach is a total loading dose divided into several smaller doses given over 12–24 hours, with careful monitoring of pulse, rhythm, and symptoms. Maintenance dosing begins after the loading phase, guided by clinical response and, if indicated, serum levels. In stable outpatients, clinicians commonly avoid loading and instead start low and titrate thoughtfully.

Situations that often favor a lower maintenance dose include:

• advanced age or low body weight
• chronic kidney disease or fluctuating renal function
• concomitant use of medications that raise digoxin levels (e.g., amiodarone, verapamil)

Therapeutic drug monitoring and target serum levels

Because of its narrow therapeutic index, therapeutic drug monitoring (TDM) is a cornerstone of safe digoxin use in the USA. When levels are checked, blood samples should be drawn at least 6–8 hours after the last dose—ideally right before the next dose—to avoid misinterpretation. In heart failure, many clinicians aim for trough levels around 0.5–0.9 ng/mL. Higher levels may provide no additional symptom benefit and can increase the risk of toxicity. For atrial fibrillation rate control, the optimal level depends on clinical response, tolerance, and concomitant therapies, with the lowest effective level being the goal.

Monitoring intervals vary: after starting or changing a dose, a level may be checked once steady state is reached (about a week in normal renal function, longer in renal impairment). Thereafter, levels might be rechecked if there are changes in kidney function, new interacting medications, symptoms suggesting toxicity, or significant shifts in clinical status. Routine periodic monitoring may also be considered in older adults or in patients with high-risk comorbidities.

Managing toxicity and overdose

Suspected digoxin toxicity is a medical urgency. Cardiac manifestations include bradycardia, AV block, and potentially life-threatening ventricular arrhythmias. Noncardiac signs include nausea, vomiting, abdominal pain, decreased appetite, confusion, weakness, and visual disturbances such as yellow or green halos. Electrolyte disturbances—especially hypokalemia—and renal impairment amplify risk.

Management begins with stopping digoxin, assessing airway/breathing/circulation, checking ECG and electrolytes, and addressing precipitating factors (for example, correcting potassium and magnesium). In moderate to severe cases, or in life-threatening arrhythmias or significant hyperkalemia, digoxin-specific antibody fragments (digoxin immune Fab; brand names such as DigiFab) are used in U.S. hospitals as the antidote. Because Fab products can interfere with standard serum digoxin assays, clinicians rely on clinical response and specialized measurements after administration.

How to take digoxin correctly

Take digoxin exactly as prescribed. Most U.S. patients take it once daily at the same time each day. It can be taken with or without food, but be consistent in your routine. If you miss a dose and it is close to the time for your next dose, skip the missed dose—do not double up. Keep all follow-up appointments, including lab tests for kidney function, electrolytes, and digoxin levels when requested by your clinician.

Be cautious with over-the-counter products and supplements. Some antacids, fiber supplements, and herbal products can reduce absorption or change blood levels. Inform your healthcare team about everything you take, including vitamins and OTC medications commonly used in the USA (such as calcium supplements, magnesium, or cold remedies).

Pregnancy and breastfeeding

In the United States, digoxin may be used during pregnancy when the potential benefits outweigh potential risks. It crosses the placenta and is sometimes used for fetal arrhythmias under specialist care. During breastfeeding, small amounts pass into breast milk; adverse effects in nursing infants are uncommon, but monitoring is prudent. Decisions regarding digoxin use in pregnancy or lactation should be made with your obstetrician and cardiologist, considering alternatives and the severity of the maternal condition.

Pharmacist’s tips for taking digoxin

In U.S. community pharmacy practice, patient counseling focuses on safety and consistency:

• Take digoxin at the same time daily, and do not change the dose unless instructed. • Report symptoms such as nausea, vomiting, visual changes, palpitations, extreme fatigue, or confusion. • Keep a current medication and supplement list. • Attend scheduled blood tests, especially if your dose changes or you start a new medicine. • Ask your pharmacist before taking new OTC products, antacids, or herbal supplements.

If you receive diuretics or other medications that affect electrolytes, your clinician may order periodic checks of potassium and magnesium. Maintaining normal electrolytes can reduce the risk of digoxin-related arrhythmias.

Safety Precautions

Do not take digoxin if you are allergic to it or to any of its components. Digoxin is contraindicated in ventricular fibrillation. Use great caution—under specialist guidance—if you have advanced AV block, sick sinus syndrome without a pacemaker, severe bradycardia, or acute myocardial infarction with instability. Correct low potassium and magnesium and avoid excessive calcium before initiating or adjusting therapy. Patients with thyroid disease, renal impairment, or low body mass require individualized dosing and closer follow-up.

Alcohol can complicate heart rhythm management and contribute to electrolyte abnormalities; discuss your alcohol intake with your clinician. Seek medical advice promptly if you experience signs of worsening heart failure (rapid weight gain, increasing shortness of breath, swelling of legs) or suspected toxicity.

Digoxin side effects

Like any medication, digoxin may cause side effects, with risk increasing at higher serum levels. Common effects include nausea, vomiting, diarrhea, decreased appetite, headache, dizziness, weakness, and fatigue. More serious reactions include arrhythmias (slow or fast), AV block, confusion, delirium (especially in older adults), and visual changes (blurred or yellow vision).

Allergic reactions are uncommon but require immediate care. Signs include rash, itching, swelling of the face or throat, severe dizziness, and trouble breathing. If you suspect a serious reaction, call emergency services or go to the nearest emergency department.

Because many symptoms overlap with other conditions (for example, GI upset from unrelated causes), U.S. clinicians often confirm with an ECG, labs, and, when appropriate, a serum digoxin level to distinguish toxicity from unrelated issues.

Symptoms by system: recognizing potential toxicity

Gastrointestinal:

• loss of appetite, nausea, vomiting, abdominal pain, or diarrhea
• unusual weakness or fatigue

Neurologic/visual:

• headache, confusion, dizziness
• visual changes (blurred vision, color disturbances such as yellow or green tinge, halos)
• anxiety or restlessness

Cardiac:

• palpitations, slow pulse, irregular heartbeat
• lightheadedness, fainting, low blood pressure
• worsening shortness of breath or swelling

If you notice these symptoms, contact your healthcare provider promptly. Severe or rapidly worsening symptoms warrant emergency evaluation.

Reporting side effects

If you experience side effects, notify your clinician or pharmacist. In the USA, you can also report adverse events to the FDA MedWatch program at www.fda.gov/medwatch or by calling 1-800-FDA-1088. Reporting helps improve the safe use of medications nationwide.

Digoxin: interactions with other medicines

Digoxin interacts with several prescription and nonprescription products. Always tell your U.S. healthcare team about all drugs and supplements you take. Some interactions raise digoxin levels; others reduce absorption or increase susceptibility to arrhythmias by altering electrolytes. Your clinician may adjust your dose, check a level, or recommend alternatives based on these combinations.

Medications and products that may interact with digoxin include:

• amiodarone, dronedarone, quinidine (can raise digoxin levels)
• verapamil, diltiazem (increase levels and additive AV nodal effects)
• macrolide antibiotics such as clarithromycin or erythromycin (can raise levels through gut flora/P-gp effects)
• azole antifungals (e.g., itraconazole, ketoconazole), certain antivirals (e.g., ritonavir-boosted regimens), and cyclosporine (increase levels)
• loop and thiazide diuretics (may cause hypokalemia/hypomagnesemia, raising arrhythmia risk)
• cholestyramine, colestipol, sucralfate, certain antacids, and high-fiber supplements (can decrease absorption; separate administration times)
• St. John’s wort (may reduce levels via induction)
• other AV nodal–blocking agents (beta-blockers, non-DHP calcium channel blockers) may have additive effects on heart rate and conduction

This list is not all-inclusive. Keep an updated medication list and share it with your prescribers and pharmacist. In the United States, pharmacists are trained to evaluate interactions proactively and can coordinate with your clinician to keep your therapy safe and effective.

Recommendations from our specialists

Our U.S.-focused clinical team emphasizes the fundamentals for safe digoxin therapy: start with a conservative dose, monitor kidney function and electrolytes regularly, and check serum digoxin levels when indicated. If you’re also on diuretics, make sure your potassium and magnesium remain within normal limits. Report new symptoms promptly, especially changes in vision, worsening nausea, or palpitations. When used thoughtfully and monitored closely, digoxin can deliver meaningful symptom relief in heart failure and help achieve heart rate goals in atrial fibrillation.

Ready to support your heart? Order Digoxin today

With a valid prescription from your U.S. clinician, you can have digoxin dispensed by a trusted American pharmacy with fast, reliable delivery. Enjoy the convenience of home shipping and dedicated pharmacist support whenever you have questions about your dose, schedule, or interactions.

• Prescription required (USA) — secure and compliant ordering
• Fast, discreet delivery via licensed U.S. pharmacy services
• Genuine, FDA-approved products from reputable manufacturers
• Affordable options with generic digoxin and 90‑day supplies
• U.S.-based support from experienced pharmacists and customer care

Join countless U.S. patients who rely on professional pharmacy services for their long-term heart care. Work with your clinician to determine if digoxin is right for you, and keep your therapy on track with dependable delivery and support.

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