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Cambridgeshire and Peterborough
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 Formulary Chapter 2: Cardiovascular system - Full Chapter
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02.01.01  Expand sub section  Cardiac glycosides
Digoxin
(Tablets, Elixir, Injection)
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Formulary
Green

 

  • Injection is Hospital only. (NWAFT: unlicensed unlicensed paediatric injection)
  • Digoxin doses in the BNF may differ from those in product literature.
  • For Elixir digoxin 50 micrograms/mL: Do not dilute, measure with pipette. Special Container. 
  • Bioavailabilites are approximately: Injection 100%, Liquid 80%, Tablets 70%.
  • Caution when switching between formulations as dose adjustment will be needed. Digoxin 125 micrograms tablet is approximately equivalent to 100 micrograms liquid and to 90 micrograms IV injection.
  • NICE Do not Do Recommendation: Routine monitoring of serum digoxin concentrations is not recommended. A digoxin concentration measured within 8–12 hours of the last dose may be useful to confirm a clinical impression of toxicity or non-adherence.

 

 
Link  CUHFT: Therapeutic drug monitoring
Link  UKMI: Suggestions for Drug Monitoring in Adults in Primary Care
   
02.01.01  Expand sub section  Digoxin-specific antibody
Digoxin specific antibody fragments (Digifab)
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Restricted Drug Restricted
Red Hospital
High Cost Medicine

  • Very rarely needed and extremely expensive. Discuss with the National Poisons Centre (0344 892 0111) first

 
Link  DigiFab: Summary of Product Characteristics
Link  Toxbase: National Poisons Information Service
   
 ....
 Non Formulary Items
Digitoxin

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Non Formulary
Grey
 
Digoxin  (Lanoxin)

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Non Formulary
Grey
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
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Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

OTC

Available Over the Counter. Consider Self Care   

Green

Formulary - Can be prescribed in both secondary and primary care.   

Advice

Formulary - Specialist Advice, secondary care advice provided for primary care initiation.  

Amber No SCG

Formulary - Specialist initiation without shared care guidance.  

Amber SCG

Formulary - Specialist initiation with shared care guidance.  

Red Hospital

Restricted - Hospital only, not to be prescribed in primary care.  

Switch

Not recommended for prescribing. Switch to alternative cost-effective option.   

Black

Not recommended for prescribing in primary or secondary care.  

Grey

Not recommended as no formal application made for addition to the formulary. Contact relevant pharmacy team for further information.   

Non Formulary

Non-Formulary (category under review).  

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