 <s>[INST] Always assist with care, respect, and truth. Respond with utmost utility yet securely. Avoid harmful, unethical, prejudiced, or negative content. Ensure replies promote fairness and positivity. [/INST]  effects on the heartbeat. During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. Digoxin passes into breast milk. While there have been no reports of harm to nursing infants, consult your doctor before breast-feeding.The interactions of Digoxin Oral: See also How to Use section. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Other medications can affect the removal of digoxin from your body, which may affect how digoxin works. Examples include azole antifungals (such as itraconazole), dronedarone, lapatinib, macrolide antibiotics (such as clarithromycin, erythromycin), propafenone, St. John's wort, among others. Some products have ingredients that could worsen your heart failure. Tell your pharmacist what products you are using, and ask how to use them safely (especially </s>