2.1 Positive inotropic drugs

2.1.1 Cardiac glycosides

Digoxin
  • Tablets 62.5 micrograms, 125 micrograms and 250 micrograms (£2.10 = 125 micrograms daily)
  • Elixir 50 micrograms/ml (£5.35 = 60ml)
  • Injection 250 micrograms/ml
  • Injection 100 micrograms/ml (unlicensed special)

Indications

Dose

  • Maintenance, for atrial fibrillation or flutter
    • oral, according to renal function and initial loading dose; usual range 125-250 micrograms daily
  • Rapid digitalisation, for atrial fibrillation or flutter
    • oral, 0.75-1.5mg over 24 hours in divided doses
  • Heart failure (for patients in sinus rhythm)
    • oral, 62.5-125 micrograms once daily

Notes

  1. The above doses may need to be reduced if digoxin (or another cardiac glycoside) has been given in the preceding 2 weeks. Digoxin doses in the BNF may differ from those in product literature. For plasma concentration monitoring, blood should be taken at least 6 hours after a dose.

2.1.2 Phosphodiesterase type-3 inhibitors

Enoximone
  • Injection 100mg in 20ml
Levosimendan
  • 12.5mg/5ml solution for infusion vials (unlicensed)
Milrinone
  • Injection 10mg in 10ml

 

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