Digoxin

Abstract

Digoxin is the oldest drug in use in cardiovascular medicine. William Withering, a physician working in Birmingham in the second half of the 18th century, first described in the scientific literature the use of extracts of the foxglove plant (Digitalis purpurea), which he said had been used as a cure for dropsy, now recognized as including a description of a disease of peripheral oedema probably caused by heart failure (HF) in many cases. Foxglove extract includes digitalis alkaloids and thus digoxin, a pure alkaloid, which has a consecutive use going back nearly a quarter of a millennium. That it is still in regular use and that it remains one of the most debated and argued about of all cardiovascular drugs says a lot about the changes in our processes for evaluating and accepting therapeutic advances in cardiovascular medicine over the last half century.