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Generic "Digiter" binds to a site on the extracellular aspect of the a-subunit of the Na+/K+ ATPase pump in the membranes of heart cells (myocytes). This causes an increase in the level of sodium ions in the myocytes, which then leads to a rise in the level of calcium ions. The proposed mechanism is the following: inhibition of the Na+/K+ pump leads to increased Na+ levels, which in turn slows down the extrusion of Ca2+ via the Na+/Ca2+ exchange pump. Increased amounts of Ca2+ are then stored in the sarcoplasmic reticulum and released by each action potential, which is unchanged by Generic "Digiter". This is a different mechanism from that of catecholamines. Generic "Digiter" also increases vagal activity via its central action on the central nervous system, thus decreasing the conduction of electrical impulses through the AV node. This is important for its clinical use in different arrhythmias.

Active Ingredients: Digoxin
Inactive Ingredients: Corn starch, croscarmellose sodium, microcrystalline cellulose, pregela-tinized starch, lactose monohydrate and anhydrous lactose, silicon dioxide.

Generic "Digiter" used to treat heart failure and abnormal heart rhythms (arrhythmias). It helps the heart work better and it helps control your heart rate. This medication is sometimes prescribed for other uses.
Ask your doctor or pharmacist for more information.

For rapid effect, a larger initial loading/digitalizing dose should be given in several divided doses over 12-24 hr. Maintenance doses are determined for Generic "Digiter" by renal function. All dosing must be evaluated by individual response. In general, doses required for atrial arrhythmias are higher than those for inotropic effect.

• Adults: Generic "Digiter" dose- 0.5 -1 mg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6-12 hr intervals.
• Children >10 yr: Generic "Digiter" dose- 8-12 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6-12 hr intervals.
• Children 5-10 yr: Generic "Digiter" dose- 15-30 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6-12 hr intervals.
• Children 2-5 yr: Generic "Digiter" dose- 25-35 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6-12 hr intervals.
• Children 1-24 mo: Generic "Digiter" dose- 30-50 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6-12 hr intervals.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed.

Before taking Generic "Digiter" tell your doctor and pharmacist if you are allergic to Generic "Digiter" or any other drugs.
Tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially antacids, antibiotics, calcium, corticosteroids, diuretics (?water pills?), other medications for heart disease, thyroid medications, and vitamins.
Tell your doctor if you have or have ever had thyroid problems, heart arrhythmias, cancer, or kidney disease.
You should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you. Remember that alcohol can add to the drowsiness caused by this drug.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Observe for signs and symptoms of toxicity. In adults and older children, the first signs of overdose usually include abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and other arrhythmias. In infants and small children, the first symptoms of overdose are usually cardiac arrhythmias. If these appear, withhold drug and notify physician or health care professional immediately.

Generic "Digiter" may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: dizziness or lightheadedness; drowsiness; vision changes (blurred or yellow); rash; irregular heartbeat; upset stomach ; vomiting; diarrhea; loss of appetite; swelling of the feet or hands; unusual weight gain; difficulty breathing

Thiazide and loop diuretics, piperacillin , ticarcillin, amphotericin B, and corticosteroids and excessive use of laxatives may cause hypokalemia which may increase the risk of toxicity. Amiodarone, some benzodiazepines, cyclosporine, diphenoxylate, indomethacin, itraconazole, propafanone, propantheline, quinidine, quinine, spironolactone and verapamil may increase serum levels and may lead to toxicity (serum level monitoring/dose reduction may be required). Blood levels may be decreased by oral aminoglycosides, some antineoplastics (bleomycin, carmustine, cyclophosphamide, cytarabine, doxorubicin, methotrexate, procarbazine, incristine), activated charcoal, cholestyramine, colstipol, kaolin/pectin, metoclopramide, penicillamine, rifampin or sulfasalazine. In a small percentage (10%) of patients gut bacteria metabolize in Generic "Digiter" inactive compounds; gatifloxacin, macrolide anti-infectives (erythromycin, azithromycin, clarithromycin), tetracyclines, by killing these bacteria, will cause increased Generic "Digiter" levels and toxicity; dose may need to be decreased for up to 9 weeks. Additive bradycardia may occur with beta blockers and other antiarrhythmics (quinidine, disopyramide). Thyroid hormones may decrease therapeutic effects.

Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking Generic "Digiter", call your doctor. If you are having surgery, including dental surgery, tell the doctor that you are taking Generic "Digiter".