Centoxin Oral Solution 60ml

Uses of Centoxin Oral Solution

• Treatment of Irregular heartbeats
• Prevention of heart failure.

How does Centoxin Oral Solution work?

Centoxin Oral Solution is a cardiac glycoside. It works by correcting irregular heartbeat to a normal rhythm and increases the force with which the heart muscle contracts with every heartbeat. This makes the heart pump more efficiently and increases blood circulation throughout the body.

Side Effects of Centoxin Oral Solution

Common with excessive dosages include gastrointestinal disturbances (anorexia, nausea, vomiting, diarrhea), CNS effects (headache, fatigue, confusion, delirium), visual disturbances, arrhythmias, heart block, and long-term effects such as gynecomastia and thrombocytopenia.

Quick Suggestions:

• Take Digoxin at the same time every day.
• Notify your doctor about any other medicines you're taking to avoid drug interactions.
• Symptoms of Digoxin overdose include slow heartbeat, dizziness, lightheadedness, and breathing problems.
• Do not discontinue the use of Digoxin without consulting your doctor even if you feel better. Stopping abruptly could worsen your condition.

Indication of Centoxin Oral Solution

• Heart failure and arrhythmia often coexist, as heart failure can lead to arrhythmias and vice versa.
• Both conditions require medical attention, and treatments often involve medications, lifestyle changes, and in some cases, surgical interventions or the use of devices like pacemakers.
• Early diagnosis and management are crucial to prevent complications and improve quality of life.

Digoxin is used in the treatment of Heart failure and Arrhythmia.

Pharmacology of Centoxin Oral Solution

Digoxin is a cardiac glycoside that increases the force of myocardial contraction (positive inotropic effect) and reduces the conductivity through the atrioventricular (AV) node. It also has direct effects on vascular smooth muscle and indirect effects mediated by increased vagal activity.

Dosage & Administration of Centoxin Oral Solution

• Oral Administration:
  • Rapid Digitalization: 1-1.5 mg in divided doses over 24 hours.
  • Less Urgent Digitalization: 250-500 micrograms daily, with the possibility of dividing the dose.
  • Maintenance: 62.5-500 micrograms daily, adjusted based on renal function and heart rate response in atrial fibrillation. The typical maintenance range is 125-250 micrograms daily, with lower doses often used in elderly patients due to increased sensitivity and reduced renal function.

Use in Special Populations:

• Neonates & Children: Safe for use with appropriate dosing.
• Elderly: Require lower maintenance doses due to increased sensitivity and reduced renal function.

Interaction of Centoxin Oral Solution

• Potassium-depleting diuretics: Increase digoxin's effects and toxicity risk.
• Calcium (IV): This may cause serious arrhythmias in digitalized patients.
• Other Drugs Increasing Digoxin Levels: Quinidine, verapamil, amiodarone, and several antibiotics (e.g., erythromycin, clarithromycin).
• Drugs Reducing Digoxin Absorption: Antacids, kaolin-pectin, sulfasalazine, and certain antibiotics (e.g., neomycin, rifampin).

Contraindications

• Ventricular fibrillation.
• Hypersensitivity to digoxin or other digitalis preparations.

Pregnancy and Lactation Considerations for Digoxin (Centoxin)

Pregnancy:

Experience and Risk Assessment:

• Extensive experience with digoxin use in pregnant women, including published retrospective studies and case reports, has not identified an increased risk of major birth defects, miscarriage, or adverse maternal and fetal outcomes directly associated with the drug.
• The untreated underlying conditions for which digoxin is typically prescribed (e.g., heart failure, atrial fibrillation) present significant risks to both the mother and fetus, including the potential for worsening of the condition, preterm birth, low birth weight, and increased risk of maternal or fetal death.

Clinical Considerations:

• Heart Failure: Pregnant women with heart failure have an increased risk of preterm birth, and the severity of heart disease may worsen during pregnancy, potentially leading to maternal or fetal death.
• Atrial Fibrillation: This condition in pregnant women increases the risk of delivering a low birth weight infant. The condition may worsen during pregnancy and lead to severe outcomes, including maternal or fetal death.

Fetal/Neonatal Adverse Reactions:

• Digoxin crosses the placenta and can be detected in the amniotic fluid.
• Newborns exposed to digoxin in utero should be monitored for signs of digoxin toxicity, such as vomiting and cardiac arrhythmias.

Dose Adjustments During Pregnancy and Postpartum:

• Digoxin requirements may increase during pregnancy due to physiological changes and may decrease postpartum.
• It is essential to monitor serum digoxin levels regularly during pregnancy and after delivery to ensure appropriate dosing.

Labor and Delivery:

• There is an increased risk of arrhythmias during labor and delivery in patients taking digoxin.
• Continuous monitoring of the patient's condition is recommended during labor and delivery.

Lactation:

• Digoxin in Breastfeeding:
  • The amount of digoxin transferred through breastfeeding is minimal, up to 4% of the neonatal maintenance dose, which is generally considered not clinically significant.
  • There is no specific data on the effects of digoxin on the breastfed infant or its impact on milk production.

Precautions & Warnings

• Regular blood tests are recommended by your doctor while taking Centoxin Oral Solution to monitor the amount of digoxin in your blood as digoxin toxicity can lead to several forms of heart rhythm disturbances, vomiting, nausea, and visual disturbances.
• If you have beriberi disease caused by vitamin B1 deficiency, malabsorption syndrome (unable to absorb minerals from food), thyroid, or any lung or kidney disease, please inform your doctor before taking
• Centoxin Oral Solution so that the dose may be adjusted or an alternate medicine may be prescribed accordingly.
• Centoxin Oral Solution has a narrow therapeutic index which makes its use limited and requires close monitoring as small changes in dose or blood concentration may lead to severe adverse effects, and overdose may lead to life-threatening reactions.

Storage:

Store in a cool, dry place, out of reach of children.