Pregnancy: Risk cannot be ruled out.
Lactation: Caution advised or effect undetermined.
Contraindications: Intermittent complete heart block, second degree AV block; supra-ventricular arrhythmias caused by Wolff-Parkinson-White syndrome; hypertrophic obstructive cardiomyopathy (unless concomitant atrial fibrillation and heart failure but with caution).
Precautions: Recent infarction; sick sinus syndrome; thyroid disease; reduce dose in the elderly and in renal impairment; avoid hypokalaemia; avoid rapid intravenous administration (nausea and risk of arrhythmias).
Digitalis therapy, particularly congestive heart failure.
ORAL: Rapid digitalisation, Adults: 1-1.5 mg in divided doses over 24 hours; less urgent digitalisation, Adults: 250-500 mcg daily (higher dose may be divided). Maintenance, 62.5-500 mcg daily (higher dose may be divided) according to renal function and, in atrial fibrillation, on heart-rate response; usual range, 125-250 mcg daily (lower dose may be appropriate in elderly).
INJECTION: Adults: Emergency loading dose by IV infusion, 0.75-1 mg over at least 2 hours, then maintenance dose by mouth on the following d
Administer by direct IV inj slowly over a period of 5 min or longer, given undiluted or diluted with a fourfold of greater volume of SWFI, D5W or NS.
Diuretics, lithium, corticosteroids, carbenoxolone, lithium, other K+ depleting agents, alprazolam, amiodarone, gentamicin, indomethacin, itraconazole, captopril, verapamil, felodipine, tiapamil, flecainide, prazosin, propafenone, quinidine, quinine, beta-blockers, suxamethonium, spironolactone, tetracycline, erythromycin, trimethoprim, propantheline, adrenaline, antacids, kaolin, pectin, laxatives, cholestyramine, acarbose, salbutamol, diphenoxylate, sulphasalazine, neomycin, rifampicin, cytostatics, phenytoin, metoclopramide, penicillamine, calcium inj or supplement, other cardiac glycosides, St. John's Wort.
Usually associated with excessive dosage, include; anorexia, nausea, vomiting, diarrhoea, abdominal pain; visual disturbances, headache, fatigue, drowsiness, confusion, delirium, hallucinations, depression; arrhythmias, heart block; rarely rash, intestinal ischaemia; gynaecomastia on long-term use; thrombocytopenia reported.