Digoxin: Decline in Prescribing

Heart failure is the leading cause of hospital admission [1]. Digoxin is approved for the treatment of heart failure with reduced ejection fraction (HFrEF). The American College of Cardiology Foundation guidelines recommends the use of digoxin, unless contraindicated, to reduce hospitalization due to worsening heart failure in patients with heart failure with HFrEF [2]. Digoxin had been a mainstay of therapy for HFrEF patients and, according to some epidemiologic studies, was the most commonly prescribed drug in heart failure until the late 20th century. According to drug usage statistics in the United States (2007-2017) digoxin was the fourth most commonly prescribed drug in 2007. However, there has been a consistent decline in prescribing digoxin over time, ranking 23rd in 2017 as shown in the graph