PHARMA CODE N° 1018
Read all of this leaflet carefully before you start using
♦ Keep this leaflet. You may need to read it again.
♦ Ifyou have any further questions, ask yourdoctor or pharmacist.
♦ This medicine has been prescribed foryou, your child or the patient. Do not pass it on to others. It may harm them, even if their symptoms are the same.
♦ If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
In this leaflet:
1. What Lanoxin-PG is and what it is used for
4. Possible side effects
6. Further information
1 What Lanoxin-PG is and what it is used for
Lanoxin-PG contains a medicine called digoxin. This belongs to a group of medicines called 'cardiac glycosides'. They work by slowing down the rate while increasing the force of your heartwhen it beats.
It is used to treat certain heart problems, such as:
• heart failure
This is when your heart muscle can't pump strongly enough to supply blood around yourwhole body. It is not the same as a heart attack and does not mean that your heart stops.
• certain types of irregular heart beats
These include 'atrial flutter' or'fibrillation'. They are caused by problems in the way the upper chambers of your heart send electrical signals. They cause your heart to beat too fast or in an uneven way.
The 'PG' of Lanoxin-PG stands for 'Paediatric and Geriatric'. This product is made for use in children or the elderly, but it may be used by others. If you are a parent, guardian or carer please read 'you' or'your' as either'your child' or'the patient' in the rest of this leaflet.
2 Before you take Lanoxin-PG
♦ you are allergic (hypersensitive) to digoxin, digitoxin or any of the other ingredients of Lanoxin-PG (listed in Section 6)
♦ you have been told that you have any of the following heart problems:
- 'Second degree' or 'intermittent complete heart block'
- Certain types of 'supraventricular arrhythmias'
- 'Ventricular tachycardia' or'Ventricular fibrillation'
- 'Hypertrophic obstructive cardiomyopathy'
Your doctor should have checked your heart problem and decided that this medicine will help you. Ifyou are not sure, talk to your doctor or pharmacist before taking Lanoxin-PG.
Take special care with Lanoxin-PG
Checkwith yourdoctor or pharmacist before using your medicine if:
♦ you have recently had a heart attack (myocardial infarction)
♦ you have been told thatyou have low potassium or magnesium levels in your blood (hypokalaemia or hypomagnesaemia)
♦ you have been told thatyou have high calcium levels in your blood (hypercalcaemia)
♦ you have a heart problem caused by a lack ofvitamin B, known as 'Beri-Beri disease'
♦ you have kidney problems
♦ you have a lung problem
♦ you have thyroid problems
♦ you have digestion problems.
Ifyou are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking this medicine. Your doctor may change your dose or you may need a different medicine.
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines obtained without a prescription and herbal products.
In particular tell your doctor or pharmacist if:
♦ you have taken either digoxin or digitoxin in the last 2 weeks. Your doctor may need to change your dose.
Taking Lanoxin-PG with other medicines can change how they work or how Lanoxin-PG works. Tell yourdoctor or pharmacist ifyou are taking any of the following:
♦ medicines for stomach problems, including indigestion, diarrhoea and being sick (vomiting)
♦ medicines for heart problems, including high blood pressure (hypertension) and irregular heart beat (arrhythmia)
♦ medicines for breathing problems, like asthma
♦ medicines for cancer
♦ medicines for epilepsy
♦ medicines for anxiety or depression
♦ medicines for bacterial infections (antibiotics)
♦ medicines for fungal infections (antifungals)
♦ medicines for high cholesterol
♦ medicines for preventing organ transplant rejection
♦ medicines for problems with your immune system
♦ medicines for preventing blood clots during kidney dialysis
♦ water tablets (diuretics)
♦ the herbal remedy St John's wort (Hypericum perforatum). This should not be taken, when taking Lanoxin-PG. Ifyou already take St John's wort, speak to your doctor, as soon as possible, before you stop taking St John's wort.
If you are not sure if any of the above apply to you, talk to yourdoctor or pharmacist before taking Lanoxin-PG.
Taking Lanoxin with food
Lanoxin can be taken with most foods. However, you should avoid taking it with foods that are high in fibre, also known as 'roughage', as the amount of Lanoxin absorbed into the body may be reduced.
Pregnancy and breast-feeding
Talk to yourdoctor before taking this medicine ifyou are pregnant, might become pregnant or are breast-feeding.
Driving and using machines
You may feel dizzy, tired, have a headache or get blurred vision while taking Lanoxin. Ifthis happens, do not drive or use any tools or machines.
Important information about some of the ingredients of Lanoxin-PG
This medicine contains sugar. Ifyou have been told byyour doctorthatyou have an intolerance to some sugars, talk to yourdoctor before taking Lanoxin-PG.
3 How to take Lanoxin-PG
Always take Lanoxin-PG exactly as your doctor has told you.
You should checkwith your doctor or pharmacist ifyou are
Your doctor will have decided how much Lanoxin-PG is right
♦ It depends on what heart problem you have and how serious it is.
♦ It also depends on yourage, weight and how well your kidneys work.
♦ Your dose may go up or down depending on how you respond to the medicine. Your doctor will do checks to see how well the medicine is working. These may involve blood and urine tests.
Taking this medicine
♦ It is important that you take the right amount. You should measure your dose using the pipette, a syringe or a measuring cup.
♦ It should be swallowed without mixing with any other liquids.
PHARMA CODE N° 1018
• You usually take this medicine in two stages:
Stage 1 - loading dose
The loading dose gets your Lanoxin-PG levels up to the correct level quickly. You will either:
- take one large single dose and then begin your maintenance dose or
- take a smaller dose each day for a week and then begin your maintenance dose.
Stage 2 - maintenance dose
After your loading dose you will take a much smaller dose every day, until your doctor tells you to stop.
Adults and children over 10 years
• loading dose
- Usually between 0.75 and 1.5 mg (15 and 30 ml) as a single dose.
- For some patients, this may be given in divided doses 6 hours apart.
- Alternatively, between 0.25 and 0.75 mg (5 and 15 ml) may be given each day for a week.
• maintenance dose
- Your doctor will decide this, depending on your response to Lanoxin-PG.
- It is usually between 0.125 and 0.25 mg (2.5 and 5 ml) daily.
Children under 10 years
• loading dose
- This is worked out using your child's weight
- Usually between 0.025 and 0.045 mg (0.5 and 0.9 ml) per kg of body weight.
- This should be given in divided doses between 4 and 8 hours apart.
• maintenance dose
- The doctor will decide this, depending on your child's response to Lanoxin-PG.
- It is usually a 1/5 (fifth) ora 1/4 (quarter) of the loading dose, to be taken daily.
If you use more Lanoxin-PG than you should
If you take too much or ifsomebodyelse takes your medicine by mistake, go to the hospital immediately. You may getanyofthe side effects and symptoms listed in Section 4, but these can be serious.
If you forget to use Lanoxin-PG
• Ifyou forget to take a dose, take it as soon as you remember. However, if it is almost time for the next dose, skip the missed dose.
• Do not take a double dose to make up for the one that you missed.
If you stop using Lanoxin-PG
Do not stop taking this medicine, as your heart problem may getworse. Talk to your doctor ifyou want to stop.
Ifyou have any further questions on taking this medicine, askyour doctor or pharmacist.
♦ stomach pain caused by lack of blood supply or damage to your intestines
♦ mental disturbances, you may feel confused, indifferent or unable to judge clearly
♦ weakness, tiredness or a general feeling of being unwell
♦ breast enlargement in men
♦ loss of appetite
Lanoxin-PG can very rarely cause serious irregular heart rates. Yourdoctor may do regular checks to make sure Lanoxin-PG is working safely for you.
If any of the side effects get serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
5 How to store Lanoxin-PG
Keep out of the reach and sight of children.
Do not use Lanoxin-PG after the expiry date on carton or bottle label (Exp.). The expiry date refers to the last day of that month.
Store below 25°C
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.
6 Further information
♦ The active ingredient is digoxin, each 1 ml contains 0.05 mg.
♦ The other ingredients are methyl hydroxybenzoate, sucrose (or syrup), sodium phosphate, citric acid, quinoline yellow (E104), ethanol, propylene glycol, lime flavour and purified water.
What Lanoxin-PG looks like and contents of the pack
An amber glass bottle that contains 60 ml of a yellow, lime-flavoured solution with a plastic pipette dropper cap.
Marketing Authorisation Holder and Manufacturer Marketing Authorisation Holder:
Aspen Pharma Trading Limited,
3016 Lake Drive,
Citywest Business Campus,
Dublin 24, Ireland
Service-Tel: 0800 008 7392 (+ 44 1748 828 391) Manufactured by: Aspen Bad Oldesloe GmbH, Industriestrasse 32-36,
D 23843 Bad Oldesloe, Germany
Product name Lanoxin-PG Elixir
Reference number PL 39699/0007
Leaflet date: November 2013
Lanoxin and Lanoxin-PG are registered trademark of Aspen.
All rights reserved.
4 Possible side effects
Like all medicines, Lanoxin-PG can cause side effects, although not everybody gets them. In general, the side effects tend to happen if the dose you are taking is too high, your doctor may adjust your dose.
Tell your doctor immediately if:
♦ you have palpitations, chest pain, shortness of breath or sweating.
These can be symptoms of a serious heart problem caused by new irregular heart beats. If these happen, tell your doctor immediately.
Other side effects that you should tell your doctor about, include:
Common (affects less than 1in10 people)
♦ slow or irregular heart rate
♦ feeling sick, being sick or diarrhoea
♦ skin rash that may be itchy
♦ drowsiness or dizziness
♦ visual disturbances, with blurred or yellow-green sight.
Uncommon (affects less than 1 in 100 people)
Very Rare (affects less than 1 in 10,000 people)
♦ bruising or bleeding more easily than normal