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Endogenous substances of unknown compositiondigoxin-like immunoreactive substancesDLIScan interfere with standard radioimmunoassays for digoxinThe interference most often causes results to be falsely positive or falsely elevatedbut sometimes it causes results to be falsely reducedSome assays are more subject to these failings than othersSeveral LC/MS/MS methods are available that may provide less susceptibility to DLIS interferenceDLIS are present in up to half of all neonates and in varying percentages of pregnant womenpatients with hypertrophic cardiomyopathypatients with renal or hepatic dysfunctionand other patients who are volume-expanded for any reasonThe measured levels of DLISas digoxin equivalentsare usually low0.2 to 0.4 ng/mLbut sometimes they reach levels that would be considered therapeutic or even toxic.

The loading dose gets your Lanoxin levels up to the correct level quicklyYou will either:

The balance of certain natural minerals in your bloodcalciummagnesiumpotassiumcan affect how this drug works in your bodyCertain drugs such aswater pillsdiureticsmay affect the normal balance of these mineralsTell your doctor or pharmacist if you are taking awater pillor if you have a history of mineral imbalanceAsk your doctor or pharmacist whether you should take a nutritional supplement or follow a special diet.

You should not stop using Lanoxin suddenlyStopping suddenly may make your condition worse.

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Digoxin is primarily excreted by the kidneysthereforepatients with impaired renal function require smaller than usual maintenance doses of digoxinsee DOSAGE AND ADMINISTRATIONBecause of the prolonged elimination half-lifea longer period of time is required to achieve an initial or new steady-state serum concentration in patients with renal impairment than in patients with normal renal functionIf appropriate care is not taken to reduce the dose of digoxinsuch patients are at high risk for toxicityand toxic effects will last longer in such patients than in patients with normal renal function.

In selecting a LANOXIN dosing regimenit is important to consider factors that affect digoxin blood levelse.gbody weightagerenal functionconcomitant drugssince toxic levels of digoxin are only slightly higher than therapeutic levelsDosing can be either initiated with a loading dose followed by maintenance dosing if rapid titration is desired or initiated with maintenance dosing without a loading dose.

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