Is It Safe to Stop Digoxin?

digoxinBecause stopping treatment with digoxin drug (Lanoxin, GlaxoSmithKline), an antiarrhythmic agent, is associated with worsening symptoms of heart failure, the American College of Cardiology and the American Heart Association recommend keeping the treatment going drug. But little is known about the lasting effects of discontinuing long-term generic digoxin therapy in patients with ambulatory chronic heart failure.

In a multicenter study, researchers looked at data on 3,365 of 7,788 patients in the Digoxin Investigation Group trial. The patients were randomly assigned to stop or continue their long-term digoxin treatment.

Discontinuation of therapy was associated with a long-term increase in hospital admissions, but no such increase was observed in mortality rates in ambulatory patients with heart failure who were receiving angiotensin-converting enzyme (ACE)-inhibitors and diuretics. However, the data also suggested that continuing long-term therapy at low serum (buy) digoxin concentrations (i.e., 0.5-0.9 ng/mL) was associated with fewer hospital admissions and reduced mortality rates.

Mortality rates from all causes were 38% among patients who discontinued their long-term digoxin therapy, 32% among those with low serum digoxin concentrations, and 45% among those with high serum concentrations. Of those patients who stopped digoxin treatment, 70% were hospitalized, compared with 66% of those with low serum digoxin levels and 69% of those with high serum concentrations.

(Source: Am J Cardiol 2007;