Digoxin Use in Modern Medicine

Shan Chen, PharmD Candidate; Troy Khusial, PharmD Candidate; Dipen Patel, PharmD Candidate; Satinder Singh, PharmD Candidate; Tatyana Yakubova, PharmD Candidate; Amy Wang, PharmD, BCPS, MBA; Timothy Nguyen, PharmD, BCPS, CCP, FASCP


US Pharmacist. 2015;40(2):44-48. 

In This Article

Digoxin and PAH

PAH is a progressive disease in which restricted blood flow through the pulmonary arteries leads to increased pulmonary vascular resistance and, ultimately, right HF. PAH is defined by an increase in pulmonary arterial pressure of >25 mmHg at rest or 30 mmHg with exercise.[7] Current treatment options for PAH include supportive therapy and concurrent medications including digoxin, diuretics, warfarin, and calcium channel blockers (CCBs).

Pulmonary hypertension is often associated with neurohormonal sympathetic activation, so digoxin may be used because of its sympatholytic properties. Current PAH guidelines briefly mention the use of digoxin for its beneficial effects on cardiac output and on circulating norepinephrine. Hence, the use of digoxin in PAH patients is based on the physician's clinical judgment.[11] The use of digoxin in PAH has not been evaluated extensively, and its mechanism of action is unknown.[12,13] No prospective, randomized trials have been conducted.[13,14]