Sometimes doctors are too quick to prescribe a pill and send you on your way, never checking back in on how you’re doing. This is turning out to be the case—with dire consequences—for many people with atrial fibrillation who take digoxin (Lanoxin, Cardoxin, Digitek, Lanoxicaps) to treat atrial fibrillation. It’s doing a lot more harm than good. In fact, it might be killing you.
But is the danger from the drug…or how it is being prescribed?
DISCOVERING DIGOXIN’S BIG RISK
Atrial fibrillation (A-fib, for short) is essentially a rapid, fluttering heartbeat. The newly discovered dangers of digoxin come from one of the country’s top health research institutions, Kaiser Permanente in California. Rather than study the potential danger of digoxin in patients with A-fib who also currently have heart disease and are known to be in poor health (which would skew the results), the researchers conducted a large study in a very diverse patient population–14,800 people. It included patients who had no prior history of heart attack and were just recently diagnosed with A-fib and began taking digoxin.
The researchers looked through the patients’ medical records to rule out other causes of death or hospitalization and also to compare use of digoxin for A-fib and treatment outcomes. It found that patients given digoxin for A-fib had a 71% higher risk of death and 63% higher risk of being hospitalized compared with patients not given digoxin for A-fib. With such deadly statistics, you would think everyone on it should drop it right now—but there is more to the story.
SAFE USE OF DIGOXIN
A-fib affects about 2.5 million Americans. Doctors used to think of it as a minor problem, but that sentiment has changed to where, now, it’s considered a serious health concern. The A-fib flutter is the effect of irregular electrical heart-rhythm impulses. This irregular pumping can lead to pooled blood in the heart, which, in turn, can cause clots that travel throughout the body, including into the brain. This is why people with A-fib often have a higher risk of stroke.
Digoxin, which works by strengthening heart contractions, is often prescribed to control heart rhythm in people with A-fib. It’s derived from a compound called digitalis, which has been used for more than 100 years to control A-fib, and comes from the foxglove plant. But, after all this time, there hasn’t been much information about the long-term safety of digoxin until the Kaiser Permanente study. It’s not that digoxin is completely unsafe, but it’s use must be monitored.
This was the final word of the Kaiser Permanente researchers who pointed out that an overdose or overaccumulation of digoxin in your body (“digoxin toxicity”) is known to cause death from irregular heartbeat. Although specific causes of deaths were not assessed in the study, digoxin toxicity might have been a primary factor. Here’s why: About 30% of the digoxin users had never had their digoxin blood levels checked after starting the drug…and another 27% had had their levels checked only once. Meanwhile, in those users who did have their digoxin blood levels checked at least once, concentrations tended to be significantly higher in users who died. So the problem may not be the drug exactly, but how much it accumulates in the body over time and a lack of monitoring by doctors.
WHAT YOU CAN DO
If you’re already on digoxin or a doctor thinks it is the best option for you to control A-fib, the Kaiser Permanente researchers don’t think that you should flatly refuse to take it. Instead, they concluded that digoxin should be “used with caution.” That means that your doctor should routinely check your blood levels and A-fib symptoms while you are taking the drug and adjust the dose or stop the drug as needed. If your doctor doesn’t automatically suggest these precautions, request them.