What are the similarities and differences between Lanoxin (digoxin) and digoxin?

From the Guidelines

Lanoxin and digoxin are essentially the same medication, with digoxin being the generic name and Lanoxin being a brand name, and they have the same active ingredient and mechanism of action in the body. The primary use of digoxin is to treat heart failure and certain types of irregular heart rhythms, such as atrial fibrillation 1.

Key Points to Consider

• The typical maintenance dose of digoxin ranges from 0.125 to 0.25 mg daily, which must be individualized based on the patient's kidney function, age, and other factors 1.
• Digoxin has a narrow therapeutic window, meaning the difference between an effective dose and a toxic dose is small, so blood levels are often monitored (therapeutic range is typically 0.8-2.0 ng/mL) 1.
• The medication works by inhibiting the sodium-potassium ATPase pump in cardiac cells, which ultimately increases the force of heart contractions while slowing heart rate 1.
• Patients should be aware that many medications and even some foods can interact with digoxin, potentially affecting its levels in the body, and signs of toxicity include nausea, vomiting, visual disturbances, and cardiac arrhythmias 1.

Clinical Considerations

• Digoxin may be considered in patients with persistent symptoms of heart failure during therapy with diuretics, an ACEI (or ARB), and a beta-blocker 1.
• It is also used in patients with heart failure and chronic atrial fibrillation, but beta-blockers are usually more effective when added to digoxin in controlling the ventricular response 1.
• The decision to use digoxin should be based on the individual patient's condition, and it is essential to monitor serum electrolytes and renal function regularly to minimize the risk of toxicity 1.

From the FDA Drug Label

Digoxin is one of the cardiac (or digitalis) glycosides, a closely related group of drugs having in common specific effects on the myocardium. Digoxin is described chemically as (3β,5β,12β)-3-[( -2,6-dideoxy-β- -hexopyranosyl-(1→4)- -2,6-dideoxy-β- -hexopyranosyl-(1→4)-2,6-dideoxy-β- -hexopyranosyl)oxy]-12,14-dihydroxy-card-20(22)-enolide.

The main similarities between Lanoxin (digoxin) and digoxin are:

• They are the same drug, with digoxin being the active ingredient in Lanoxin
• They have the same chemical structure and molecular formula
• They are used for the same medical purposes, including the treatment of heart failure and atrial fibrillation

The main differences between Lanoxin (digoxin) and digoxin are:

• Brand name vs generic name: Lanoxin is a brand name, while digoxin is the generic name
• Formulation and inactive ingredients: Lanoxin may have different inactive ingredients or formulations compared to generic digoxin 2, 2

From the Research

Similarities between Lanoxin (digoxin) and digoxin

• Lanoxin and digoxin are therapeutically equivalent, as shown in a study comparing medigoxin (Lanitop) and digoxin (Lanoxin) in the control of atrial fibrillation 3
• Both are used to treat heart problems, including congestive heart failure, atrial fibrillation or flutter, and certain cardiac arrhythmias 4, 5
• They have similar serum glycoside concentrations and ventricular rates in healthy volunteers and patients with uncontrolled atrial fibrillation 3

Differences between Lanoxin (digoxin) and digoxin

• The bioavailability of digoxin in solution (Lanoxicaps) is superior to that of Lanoxin tablets in young healthy volunteers, but similar in elderly patients 6, 7
• Lanoxicaps have a lower clearance rate and more complete absorption compared to Lanoxin tablets 3
• The renal clearance of serum glycoside is lower during medigoxin administration compared to digoxin administration 3
• Steady-state digoxin concentrations were statistically significantly different between Lanoxin and Lanoxicaps in elderly patients, with Lanoxin having higher concentrations 6
• Lanoxicaps may result in subtherapeutic serum concentrations due to lower than expected bioavailability in elderly patients 6