Brand Name

Toloxin {Pharmascience Inc./PENDOPHARM }

Generic Name

digoxin, pronounced di JOX in

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Drug Guide

The information contained in the following drug guide is intended as an educational resource only. This guide is not exhaustive and does not contain all available information about this drug.This guide is not intended as medical advice for individual conditions or treatment.

The information provided in this guide does not replace the need for the advice and services of medical professionals or the need for medical examination. Always talk to your physician or pharmacist before taking any prescription medication or over the counter drugs (including any supplements) or before making any changes to your treatment. Only your doctor, nurse or pharmacist can provide you with safe and effective advice regarding your drug treatment.

The use of the information in this guide is at your sole risk. This information is provided "AS IS" with no warranties to accuracy or timeliness.

**All trademarks and registered trademarks are the property of their respective owners.

What is Toloxin?

Toloxin is a medication that treats heart failure and atrial fibrillation, which is a heart rhythm disorder of the atria. Toloxin is derived from the leaves of a digitalis plant and works by helping your heart to beat stronger and with a more regular rhythm.

Toloxin may also be used for reasons not stated in this medication guide.

Key Facts About Toloxin

If you have you have ventricular fibrillation, which is a heart rhythm disorder of the ventricles (lower chambers) of your heart you should not take Toloxin.

You should not stop taking Toloxin without taking to your doctor, as stopping this medication suddenly may make your condition worse.

Take care to avoid becoming dehydrated or overheated during exercise and outdoors in hot weather. You must drink enough fluids when you exercise or spend time in the heat. An overdose can occur easily if you are dehydrated and take Toloxin.

Tell your doctor if you are pregnant or plan to become pregnant. Toloxin is in FDA pregnancy category C. It is not known if Toloxin may cause problems in your newborn. Consult with your doctor if you become pregnant while taking Toloxin. You should not breastfeed while taking Toloxin, as we know if Toloxin can pass into breast milk and may harm a nursing baby.

Toloxin is more likely to cause side effects in older adults and the elderly.

Before You Take Toloxin

If you are allergic to digoxin you should not take Toloxin.

If you a heart condition, particularly “AV block” (if you do not have a pacemaker) or if you have a recent history of a heart attack you should tell your doctor before taking Toloxin.

Tell your doctor if you have kidney disease or a thyroid disorder before taking Toloxin.

You should let your doctor know if you have an electrolyte imbalance like low levels of calcium, magnesium or potassium in your blood before taking Toloxin.

If you have recently been ill with vomiting or diarrhea, or if you are malnourished you should talk to your doctor before beginning treatment with Toloxin.

Toloxin Drug Interactions

You should inform your doctor if you are taking any of the following:

• alprazolam (Xanax)
• amphotericin B (Fungizone)
• antacids, like Kaopectate
• antibiotics like erythromycin (EryPed,Ery-Tab), clarithromycin (Biaxin) or tetracycline (Brodspec or Panmycin)
• calcium supplements
• cancer medications
• cholestyramine (Questran)
• clonidine (Catapres)
• diuretics (water pills)
• decongestant cold or allergy medications, or nasal sprays like Afrin, Duramist and Neo-Synephrine
• epinephrine (EpiPen)
• heart or blood pressure medications like amlodipine
• Norvasc, Caduet), carvedilol (Coreg), diltiazem (Cardizem, Cartia, Dilacor, Diltia, Tiazac), metoprolol (Dutoprol, Lopressor, Toprol), nebivolol (Bystolic), nifedipine (Nifedical, Procardia), verapamil (Calan, Covera, Isoptin, Verelan)
• heart rhythm medications like amiodarone (Cordarone, Pacerone), propafenone (Rythmol) and quinidine (Quin-G)
• indomethacin (Indocin)
• isoproterenol (Isuprel)
• itraconazole (Sporanox)
• levothyroxine (Synthroid)
• metoclopramide (Reglan)
• neomycin (Mycifradin,Neo-Fradin)
• rifampin (Rifadin)
• spironolactone (Aldactone)
• St. John’s wort
• steroids like prednisone, fluticasone (Advair), mometasone (Asmanex, Nasonex) and dexamethasone (Decadron, Hexadrol)
• sulfasalazine (Azulfidine)

Other drugs you take that are not listed may interact with Toloxin. You should tell your doctor about all of the medications you use. This includes prescription drugs, vitamins, supplements and herbal products, and over the counter medications. You should not begin taking a new medication without telling your doctor first.

Directions for Taking Toloxin

You should take Toloxin exactly as directed by your doctor. It is important that you do not take Toloxin in larger or smaller amounts, or for longer or shorter than recommended. Follow the directions on your prescription label and follow any dose changes carefully if your doctor instructs you to change your dose.

Toloxin may be taken with or without food.

You should take Toloxin with a full glass of water.

Toloxin should be taken at the same time each day.

You may need to have your blood tested on a regular basis while you are taking Toloxin, especially to check your kidney function. Take care to keep your regular doctor appointments while you are taking Toloxin.

Toloxin needs to be stored at room temperature, and away from light, moisture and heat. Keep your bottle tightly closed when you are not using it.

If you miss a dose of Toloxin you should attempt to take the missed dose as soon as you remember. However, if it is less than 12 hours away until your next scheduled dose wait for your next dose. Do not take the missed dose in addition to your regular dose.

Toloxin Side Effects

If you experience any of the following adverse effects you should stop taking Toloxin and seek emergency medical help immediately:

• allergic reactions such as breathing difficulties, hives, or swelling of your face, lips, throat or tongue
• black, bloody or tarry stools
• blurred vision
• confusion
• hallucinations
• unusual thoughts or behavior
• yellowed vision

Less serious side effects of Toloxin may include:

• anxiety
• appetite loss
• depression
• diarrhea
• dizziness
• enlarged breasts in men
• headache
• nausea
• mild skin rash
• vomiting
• weakness

It should be noted that this is not a complete list of possible side effects of Toloxin. You should contact your physician for a complete list and medical advice regarding these effects.

Toloxin Description and Dosing

Toloxin is available in a 0.0625 mg tablet, a 0.125 mg tablet and a 0.25 mg tablet. The 0.0625 mg tablet is round, peach colored, flat-faced, beveled edge and debossed “TOLOXIN” over a score line and “06” under it on one side and plain on the other side.

The 0.125 mg tablet is round, yellow colored, flat-faced, beveled edge and debossed “TOLOXIN” over a score line and “12” under it on one side and plain on the other side.

The 0.25 mg tablet is round, white, biconvex and debossed “TOLOXIN” over a score line and “25” under it on one side and plain on the other side.

You should consult your doctor for specific dosing pertaining to you. Do not attempt to alter or change your dose without your physician’s consent.

If you suspect that you have overdosed with Toloxin you should seek emergency help immediately.

Ingredients in Toloxin

Toloxin is comprised of the main ingredient digoxin. Other ingredients in the 0.0625 mg tablets include FD&C Yellow No. 6, lactose, magnesium stearate, and starch (corn). The 0.125 mg tablets also contain D&C Yellow No. 10, lactose, magnesium stearate, starch (corn), and yellow ferric oxide. The 0.25 mg tablets contain lactose, magnesium stearate, and starch (corn).

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The information contained in this drug guide is intended as an educational resource only. This guide is not exhaustive and does not contain all available information about this drug.This guide is not intended as medical advice for individual conditions or treatment.

The information provided in this guide does not replace the need for the advice and services of medical professionals or the need for medical examination. Always talk to your physician or pharmacist before taking any prescription medication or over the counter drugs (including any supplements) or before making any changes to your treatment. Only your doctor, nurse or pharmacist can provide you with safe and effective advice regarding your drug treatment.

The use of the information in this guide is at your sole risk. This information is provided "AS IS" with no warranties to accuracy or timeliness.

**All trademarks and registered trademarks are the property of their respective owners.