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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. </p></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK501845_"><span class="title" itemprop="name">Digoxin</span></h1><p class="small">Last Revision: <span itemprop="dateModified">September 15, 2024</span>.</p><p><em>Estimated reading time: 2 minutes</em></p></div><div class="body-content whole_rhythm" itemprop="text"><p>CASRN: 20830-75-5</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/134995250" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=134995250" alt="image 134995250 in the ncbi pubchem database" /></a><div id="LM93.Drug_Levels_and_Effects"><h2 id="_LM93_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM93.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Because of the low levels of digoxin in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. If the mother is to receive digoxin intravenously, avoidance of breastfeeding for 2 hours after the dose will lessen the dose the infant receives.</p></div><div id="LM93.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> In 11 women taking digoxin 0.25 mg daily orally, milk digoxin levels obtained on days 3 to 7 postpartum were relatively constant at 0.644 mcg/L.[<a class="bk_pop" href="#LM93.REF.1">1</a>] The amounts in milk represent an infant dosage of about 2.3% of the maternal weight-adjusted dosage or 0.097 mcg/kg daily, which is about 1% of the neonatal maintenance dosage.</p><p>Milk digoxin levels were 0.41 and 0.78 mcg/L in two mothers taking oral digoxin 0.25 mg daily.[<a class="bk_pop" href="#LM93.REF.2">2</a>]</p><p>Milk digoxin levels ranged from undetectable (<0.5 mcg/L) to 1 mcg/L in 5 women treated with unspecified doses of digoxin. Milk and serum levels were similar.[<a class="bk_pop" href="#LM93.REF.3">3</a>]</p><p>A milk digoxin level of 1.9 mcg/L was measured in a mother taking 0.75 mg daily of digoxin during pregnancy and postpartum.[<a class="bk_pop" href="#LM93.REF.4">4</a>]</p><p>After an intravenous bolus dose of digoxin 0.5 mg in 11 women, digoxin serum and milk levels rapidly equilibrated, with high levels occurring rapidly, dropping to low levels by about 2 hours after the dose. A pharmacokinetic simulation using data from these mothers indicate that a fully breastfed infant would obtain a serum level of only about 3% of a therapeutic level with maternal intake of 0.5 mg daily of digoxin.[<a class="bk_pop" href="#LM93.REF.5">5</a>]</p><p><i>Infant Levels.</i> In two breastfed infants whose mothers were taking oral digoxin 0.25 mg daily, digoxin was undetectable (< 0.1 mcg/L) in their serum after 10 days of maternal therapy.[<a class="bk_pop" href="#LM93.REF.2">2</a>]</p><p>A mother took 0.75 mg daily of digoxin during pregnancy and postpartum. Her infant had a serum level of 0.2 mcg/L after nursing for 7 days, having decreased from a level of 0.6 mcg/L at birth.[<a class="bk_pop" href="#LM93.REF.4">4</a>]</p></div><div id="LM93.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>At least 4 infants have been reported to have been breastfed in studies on digoxin in breastmilk. None had any detectable digoxin effect.[<a class="bk_pop" href="#LM93.REF.2">2</a>,<a class="bk_pop" href="#LM93.REF.4">4</a>,<a class="bk_pop" href="#LM93.REF.6">6</a>]</p></div><div id="LM93.Effects_on_Lactation_and_Breastmilk"><h3>Effects on Lactation and Breastmilk</h3><p>Relevant published information was not found as of the revision date.</p></div><div id="LM93.References"><h3>References</h3><dl class="temp-labeled-list"><dt>1.</dt><dd><div class="bk_ref" id="LM93.REF.1">Chan
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V, Tse
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TF, Wong
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V. Transfer of digoxin across the placenta and into breast milk.
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Br J Obstet Gynaecol
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1978;85:605-9.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/687540" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 687540</span></a>]</div></dd><dt>2.</dt><dd><div class="bk_ref" id="LM93.REF.2">Loughnan
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PM. Digoxin excretion in human breast milk.
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J Pediatr
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1978;92:1019-20.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/660341" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 660341</span></a>]</div></dd><dt>3.</dt><dd><div class="bk_ref" id="LM93.REF.3">Levy
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M, Granit
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L, Laufer
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N. Excretion of drugs in human milk.
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N Engl J Med
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1977;297:789.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/895815" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 895815</span></a>]</div></dd><dt>4.</dt><dd><div class="bk_ref" id="LM93.REF.4">Finley
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JP, Waxman
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MB, Wong
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PY, et al.
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Digoxin excretion in human milk.
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J Pediatr
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1979;94:339-40.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/762640" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 762640</span></a>]</div></dd><dt>5.</dt><dd><div class="bk_ref" id="LM93.REF.5">Reinhardt
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D, Richter
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O, Genz
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T, et al.
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Kinetics of the transplacental passage of digoxin from breast feeding mothers to their infants.
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Eur J Pediatr
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1982;138:49-52.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/7075628" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7075628</span></a>]</div></dd><dt>6.</dt><dd><div class="bk_ref" id="LM93.REF.6">Miller
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MR, Withers
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R, Bhamra
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R, et al.
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Verapamil and breast-feeding.
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Eur J Clin Pharmacol
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1986;30:125-6.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/3709626" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3709626</span></a>]</div></dd></dl></div></div><div id="LM93.Substance_Identification"><h2 id="_LM93_Substance_Identification_">Substance Identification</h2><div id="LM93.Substance_Name"><h3>Substance Name</h3><p>Digoxin</p></div><div id="LM93.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>20830-75-5</p></div><div id="LM93.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Milk, Human</p><p>Antiarrhythmics</p><p>Cardiac Glycosides</p></div></div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></div><div id="bk_toc_contnr"></div></div></div>
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