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Dr. Andrew Rynne

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Should Digoxin Be Gradually Weaned Off Due To Increased Costs?

Taking metoprolol for 20 years for mild mitral valve prolapse. Had pulmonary embolism 3 years ago, resulting in atrial fibrillation. Was prescribed digoxin and warfarin. Of course everything has less than salubrious effect on everything, especially digoxin/metoprolol. Is it a bad idea to slowly go off lanoxin? Since drug company has consolidated with another and thus restricted the supply, the cost of digoxin in the drug plan has gone from $20 for 90 day supply to $120.
Tue, 7 Aug 2018
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General Surgeon,  's  Response
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.

Digoxin should not be stopped without the permission of your treating cardiologist. Weaning of from digoxin makes your heart weaker and predispose to fibrillation and arrhythmia. And mitral valve prolapse makes the pumping little bit weak and thus require digoxin support. However if the ejection fraction is good we can taper the dose. Take a fresh echo cardiograph and consult your cardiologist, he can direct you accordingly.

Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Shinas Hussain
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Should Digoxin Be Gradually Weaned Off Due To Increased Costs?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Digoxin should not be stopped without the permission of your treating cardiologist. Weaning of from digoxin makes your heart weaker and predispose to fibrillation and arrhythmia. And mitral valve prolapse makes the pumping little bit weak and thus require digoxin support. However if the ejection fraction is good we can taper the dose. Take a fresh echo cardiograph and consult your cardiologist, he can direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain