Toloxin is a cardiac glycoside with the active ingredient Digoxin (also available in a generic form). This medication is used to treat heart failure, abnormal heart rhythms, atrial fibrillation, congestive heart failure, and other types of heart conditions.

Available as both a solution and a tablet, Toloxin is taken orally to increase the strength of the heart so that it works optimally. Digoxin also comes in various brand names with different forms and dosages.

How Toloxin Works

Toloxin controls heart failure symptoms by slowing down your heart rate. This helps to strengthen your heartbeat and enable the heart to pump more blood around the body.

The medication has two main mechanisms of action, namely:

  • Positive ionotropic: Toloxin improves heart contraction force by inhibiting the action of the myocardial Na-K ATPase pump, which increases sodium levels and concertation of calcium in the heart. An influx of these ions increases the force of contraction.
  • AV node inhibition: By inhibiting the atrioventricular node, Toloxin slows conduction, hence reducing ventricular rate during atrial fibrillation.

Toloxin Precautions and Warnings

Important warnings and precautions need to be considered before using Toloxin. Observing these warnings will reduce the chances of adverse effects and ensure the safe use of this drug.

  • Potential Overdose: Your doctor should carry out necessary blood tests to make sure they’re prescribing the appropriate dosage of Toloxin because it has a narrow therapeutic index, which could result in an overdose. If you notice signs of Toloxin overdose, such as vomiting, nausea, and loss of appetite, contact your doctor immediately.
  • Breastfeeding: While digoxin is secreted in human milk, the amount passed over to the infant is too small to harm them. However, breastfeeding women should consult with a doctor before taking the medication.
  • Children: Toloxin is safe for pediatric use, but a doctor should strictly determine the exact dosage. Even better, doctors should also closely monitor children and suggest dosage adjustments for effectiveness.
  • Kidney Function: Patients suffering from kidney disease or impaired kidney function should take Toloxin cautiously. Delayed filtering of the medication due to renal failure can lead to drug build-up and toxicity. Your doctor may recommend dosing adjustments and special monitoring to avoid this.
  • Thyroid Disease: Since Toloxin regulates heart rate, Thyroid disease can alter its function and affect heart rhythm. People suffering from thyroid disease should consult a doctor for the correct dosage and monitoring to avoid adverse effects.
  • Magnesium and Potassium Levels: Always check your potassium and magnesium levels periodically when using this medicine. Low levels of these nutrients can increase the risk of an overdose and side effects of Toloxin.

Toloxin Side Effects

Side effects vary in severity and the time they take before they disappear. While some effects are mild and take a short time to disappear, others are severe and may need treatment to go away. In rare care cases, side effects may even be permanent. The following side effects may occur in some patients taking Toloxin.

Common Side Effects

Mild unwarranted effects occur as your body adjusts to the drug. These do not require any medical intervention, as they disappear independently after some time.

  • Headache
  • Dizziness
  • Nausea
  • Decreased appetite
  • Abdominal pain
  • Weakness
  • Unusual tiredness
  • Decreased sexual desire
  • Anxiety

Severe Side Effects

Severe unwanted effects mainly occur because your body reacts to one of the ingredients in the drug. Severe side effects could also happen because the drug is destroying healthy body cells in addition to killing unwanted cells.

These effects will require you to seek immediate medical intervention. Besides providing treatment for the side effects, your doctor may suggest dosage adjustments or may ask you to stop taking Toloxin and replace it with a well-tolerated alternative.

  • Confusion
  • Slow heartbeat
  • Mental disturbances
  • Seizures
  • Severe headaches
  • Speedy heart rate
  • Fainting
  • Vision changes
  • Diarrhea
  • Severe allergic reaction symptoms
  • Hallucinations
  • Signs of depression such as changes in sleep, thoughts of suicide, lack of interest in things, etc.

Side Effects for Pediatric Patients

Generally, most of the side effects that happen to adults also occur in children and infants. However, children are more likely to experience side effects related to heart rate, such as fast or slow heartbeat. Other side effects like headaches, changes in vision, and stomach upsets may appear later.

Toloxin Drug Interactions

Due to the interaction of Toloxin with different kinds of drugs, the medication should be carefully individualized for patients receiving other administered medications. Some medicines that interact with Toloxin resulting in severe effects, include:

Drug/Food Interaction
Alprazolam The interaction between Toloxin and alprazolam may result in Toloxin toxicity causing symptoms like vomiting and nausea,
Bran fiber When Toloxin interacts with food rich in fiber, the amount of Toloxin absorbed into the body is reduced hence making the drug less effective.
Omeprazole Concurrent use may result in an increased risk of Toloxin toxicity leading to diarrhea, vomiting, and nausea.
Albuterol (found in Proair Respiclick) Interaction between these two medications may lead to decreased serum Toloxin concentration, by redistributing the drug to other tissues of the body
Potassium Potassium may interact with Toloxin resulting in toxicity due to a decrease in serum potassium concentration.

Toloxin Strengths and Dosages

The dosage of Toloxin should be determined on clinical grounds and can vary based on factors like age, specific health conditions, weight, and how well your kidneys function.

Age Dosage No. of times a day
Children (2-5) years 10-15mcg/kg 3 times a day (after every 6 hours)
Children (5-10) years 7-10mcg/kg 3 times a day (after every 6 hours)
Children over 10 years 3-5mcg/kg 3 times a day (after every 6 hours)
Adults 18 years and above 0.25mg Once per day


Adults usually take Toloxin orally as a single daily dose. For young children and infants, a divided daily dose is generally administered based on the age and weight of the patient.

Typically, higher doses might be prescribed to ensure the medication reaches the necessary levels in the body for the intended effect.

If you miss a dose, you are advised to take it as soon as you remember, within 12 hours of the scheduled dose, but do not double it. Consider speaking with your doctor if you miss a dose for more than two consecutive days or if you take an overdose.

Toloxin Alternatives

It is essential to consult your doctor to determine the most effective and appropriate alternative based on your medical history and condition. Besides Toloxin, different alternative medications can work similarly in preventing heart failure in patients. They include:

  • Metoprolol: A medication used as a beta-blocker to lower blood pressure and prevent angina symptoms. The drug is usually prescribed to treat different conditions like heart failure, heart attack, and atrial fibrillation.
  • Xarelto: Used to prevent blood clots in children above two years of age with congenital heart conditions. It is also administered to patients who have coronary artery disease, cardiovascular risk reduction, and congenital heart disease.
  • Diltiazem (found in Tiazac XC)
  • Sotalol
  • Propafenone
  • Flecainide

FAQs of Toloxin

What are the side effects of Toloxin?

Patients may experience different side effects, including dizziness, diarrhea, vomiting, and nausea. However, the side effects may not affect every patient. If you experience severe side effects like irregular heartbeats, seek medical attention immediately.

What food should I avoid when taking Toloxin?

Avoid food rich in fiber, which can interfere with the absorption of Toloxin. Additionally, avoiding consuming food high in potassium, like bananas and oranges, is advisable as they increase the risk of hyperkalemia.

Who should not take this medication?

Avoid taking the medication if you have a known allergy to its components. You should also refrain from using the drug if you experience certain abnormal heart rhythms, specifically ventricular fibrillation.

What are the precautions and warnings of Toloxin?

Before commencing the medication, you must tell your doctor of any existing medical conditions, allergies, current medications, and pregnancy or breastfeeding status. Comprehensive disclosure of medical conditions is crucial for appropriate use of the medicine, as it helps your doctor make informed choices regarding the drug’s suitability for your condition.

Can I drive and operate heavy machinery when taking Toloxin?

Toloxin may cause dizziness and blurred vision; as such, it is advisable for a patient taking the medication not to drive or operate heavy machinery.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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