Cardiac glycosides dosage and evidence
Written by Aaron CuhaReviewed Sep 2026
The short answer
Two 2019 papers said these heart drugs kill worn-out cells in a dish and in mice. Separately, digoxin was tested for heart failure in one of the biggest heart studies ever, in 6,800 people. That study did not look at worn-out cells. These are two different bodies of proof, and one does not carry over to the other.
Evidence grade for Cardiac glycosides: Moderate. The rule: at least one finished study in people, and at least 100 people who took it. The sum on this page: 1 completed trial, 6,800 people given it. A grade counts how much has been done to people, not whether it works.
- People given it
- 6,800
- Human studies
- 1
- Found nothing
- 1
Dose
Approved medicine. No human dose established for unlabelled uses
Labeled amounts sit on the prescribing information. This page records what trials measured, not a personal dose.
Digoxin is an FDA-approved prescription drug for heart failure and atrial fibrillation, a common irregular heartbeat. openFDA, the FDA's public drug database, lists current prescription products plus several discontinued ones. No drug in this family is approved anywhere to clear worn-out cells or for ageing. Ouabain is not sold as a medicine in the United States.
No first-hand reports gathered yet. That is a gap in what we have collected, not a finding that nothing has been reported.
Goal pages: Ageing and longevity, Heart and circulation
In plain English
In plain English, from Aaron
This is how I would explain it to a friend. The evidence, with the numbers, is further down the page.
Cardiac glycosides are old heart drugs. Digoxin is the best known. Doctors prescribe it for heart failure and an uneven heartbeat. Two 2019 lab papers said these drugs also kill worn-out cells. That part has never been tested in people.
What people take it for
- Heart failure, which is the approved use.
- Clearing worn-out cells to slow ageing.
What studies in people showed
The big study is about the heart. 6,800 people with weak hearts took digoxin or a dummy pill for about three years. It did not save lives. 1,181 died on digoxin and 1,194 on the dummy pill. But hospital stays for heart failure fell from 34.7 percent to 26.8 percent. It did not look at worn-out cells. A small study in 100 people will check a lab marker of worn-out cells, but it has not started. In mice and in a dish, these drugs killed worn-out cells. A 2021 lab paper found worn-out cells that resisted them.
What people report
Reports, not study results
The good
- In the big heart study, digoxin kept people with heart failure out of hospital.
The bad
- The gap between a helpful dose and a harmful dose is small.
- These drugs can cause dangerous heart rhythms.
Where these come from: The results and safety points are from the studies on this page. We have not collected forum reports for this one.
My bottom line
Digoxin is a real heart drug with a real risk. Taking it for ageing on your own is a very different thing from trying a supplement. Do not.
An opinion, not a finding. I am a coach, not a doctor.
What it has been measured to do
Measured in people
Goals Cardiac glycosides has been tested for in people, biggest studies first. We count only what the studies on this page say, so the real numbers may be higher.
- Heart attacks and strokes6,800 people · 1 study · 1 found nothing
- Living longer6,800 people · 1 study · 1 found nothing
34 of the 36 indexed goals have no study of any kind behind Cardiac glycosides
No study in people, animals or cells on this page reports a result for these. That does not prove Cardiac glycosides does nothing for them. It does mean anything you have heard about Cardiac glycosides and one of these did not come from a study cited here.
Show full evidence
What is Cardiac glycosides?
Two 2019 papers said these heart drugs kill worn-out cells in a dish and in mice. Separately, digoxin was tested for heart failure in one of the biggest heart studies ever, in 6,800 people. That study did not look at worn-out cells. These are two different bodies of proof, and one does not carry over to the other.
Cardiac glycosides are old heart drugs. Digoxin is the best known. They block a pump in the cell wall that moves salt in and out.
The big study in people is about the heart. 6,800 people with weak hearts took digoxin or a dummy pill for about 37 months on average. It did not save lives. 1,181 people died on digoxin and 1,194 on the dummy pill. But it kept people out of hospital. Hospital stays for worsening heart failure fell from 34.7 percent to 26.8 percent. That study is why doctors still prescribe digoxin. It measured nothing about worn-out cells, and it is not proof that digoxin clears them in people.
One study links the two ideas, and it has not started. The University of Leeds plans to give 100 people with heart failure and type 2 diabetes a low daily dose, 0.125 mg, of digoxin or a dummy pill for three months. It will measure a lab marker of worn-out cells in blood vessel cells grown from fat tissue. It will not measure how anyone feels or how long they live. In September 2026 it was listed as not yet recruiting.
In a dish and in mice, two groups reported in 2019 that blocking the pump kills worn-out cells. Worn-out cells already sit a bit off balance, so blocking the pump tips them into dying while healthy cells survive. One paper named ouabain, a related drug, and showed it cleared worn-out cells in mice that were old or had been given radiation. The other showed the same effect in human cells in a dish, and wiped out human tumours grown in mice when paired with a drug that wears cells out first. A 2021 paper found the opposite in another setting: worn-out cells there resisted being killed. So the result is not the same everywhere.
No clean-up drug has improved health in a proper study in people.
How does Cardiac glycosides work?
Shown in human cells in a dish and in mice: blocking the cell's salt pump upsets the charge across the cell wall and makes the inside more acidic. Worn-out cells are already partly upset this way, which may be why they die first. Ouabain also switches on a protein that tells cells to die. Work on one type of worn-out cell suggests the killing needs a signal sent through the pump, not just the pump being blocked. In people, digoxin is known to make the heart pump harder and to change nerve and hormone signals. Its doses are set for the heart, not for clearing worn-out cells.
What have studies in people found about Cardiac glycosides?
Two separate things that must not be mixed up. Digoxin has decades of data in people, including a study of 6,800 people, all about heart failure. The only study in people on clearing worn-out cells measures a lab marker and has not started.
- 6,800 people with heart failure took digoxin or a dummy pill for about 37 months on average. It did not change how many died. It cut hospital stays for worsening heart failure, 26.8 percent against 34.7 percent. Paid for by the US government and industry. It measured nothing about worn-out cells.
- University of Leeds, early study, 100 people planned: digoxin or a dummy pill for three months in heart failure with type 2 diabetes. It will measure a lab marker of worn-out cells in blood vessel cells grown from fat tissue. Not yet recruiting as of September 2026.
- No published study has measured worn-out cells in people after giving any of these drugs.
What this does not tell you: The heart failure proof tells you nothing about worn-out cells. The lab work tells you nothing about what digoxin does to worn-out cells in a living person. Even if the Leeds study finds a change in its lab marker, a lab marker is not better health. These drugs have a small gap between a helpful dose and a harmful one, and they can cause dangerous heart rhythms. Nothing in the clean-up research changes that.
The state of the research
This page exists because two sets of proof with the same drug name get quoted as if they were one. Digoxin has a large, old, high-quality record in people. It was built to answer whether digoxin keeps people with heart failure alive and out of hospital. The answer: no change in deaths, fewer heart failure hospital stays. That record does not carry over to the clean-up claim just because it is the same drug.
The clean-up claim rests on two 2019 papers in human cells in a dish and in mice. One has a published correction. A 2021 paper partly contradicts them, finding worn-out cells that resist being killed. The first study in people of the clean-up idea measures a lab marker, and it had not started enrolling as of September 2026. These drugs also have a small gap between a helpful and a harmful dose, and they can cause dangerous heart rhythms. That is why trying digoxin on yourself for ageing is a very different thing from trying a supplement.
The evidence, in charts
Fig. 1a · how many people
6,800people, across 1 study in people cited here
| Study | People | Share |
|---|---|---|
| New England Journal of Medicine 1997 | 6,800 | 100% |
The whole total is one study of 6,800. Counts are the number of people each study on this page says it signed up. That includes studies that only watched people and gave nobody the compound. 1 more study in people gives no headcount and is not counted here. Studies still signing people up are left out, and only studies cited on this page are counted.
Fig. 1b · evidence mix
2 of 6 sources here are studies in people. The rest are not.
- Study in people · done in people233%
- Lab (cells in a dish) · cells or tissue467%
Counted from the list of sources on this page. It counts only what we cite, so there may be more studies out there. A review counts once, however many studies it sums up.
Fig. 2 · evidence over time
The studies cover 4 different years, 1997 to 2026, counted from the list of sources on this page.
Fig. 3 · legal status at a glance
US
Approved
UK
Approved
AU
Approved
CA
Approved
Approved in all four countries shown. This is what the law says, not a verdict on the science. See Legal status below for the full text and any notes.
Fig. 5 · what the molecule is
- Kind of compound
- Small molecule
- Molecule weight
- Not on file
- Half-life
- None on file
- Chain length
- None on file
No amino acid sequence is on file for Cardiac glycosides, which is expected: a small molecule is not built from amino acids.
The studies we cite
- Study in people1997The effect of digoxin on mortality and morbidity in patients with heart failure
Digoxin did not save lives, and it was tested well enough to say so. 6,800 people with weak hearts took digoxin or a dummy pill and were followed about three years on average. About the same share died in each group, roughly 35 percent either way. A study this big would have found a survival benefit if there was one. Digoxin did keep people out of hospital: heart failure stays fell from about 35 percent to 27 percent. This is heart failure proof. It says nothing about ageing.
6,800 patients with heart failure and ejection fraction 0.45 or less randomised to digoxin or placebo, average follow-up 37 months. Mortality unchanged: 1,181 deaths (34.8 percent) versus 1,194 (35.1 percent), risk ratio 0.99, 95 percent confidence interval 0.91 to 1.07. Hospitalisation for worsening heart failure fell from 34.7 to 26.8 percent, risk ratio 0.72. This is cardiology evidence and says nothing about senescence.
- Study in people2026Digoxin and Senolysis in Heart Failure and Diabetes Mellitus
There is a study asking whether digoxin clears worn-out cells, and it has not started. The University of Leeds plans to give 100 people a low daily digoxin dose or a dummy pill for three months. It will measure a stain on cells grown in a dish from fat tissue, not how anyone feels or how long they live. The registry listed it as not yet recruiting when we checked in September 2026.
University of Leeds, phase 2, randomised, quadruple-masked, estimated enrolment 100, digoxin 0.125 mg daily versus placebo for three months. Primary outcome is senescence-associated beta-galactosidase expression in cultured adipose microvascular endothelial cells, a laboratory marker. Status NOT YET RECRUITING, verified live September 2026.
- Lab (cells in a dish)2019Cardiac glycosides are broad-spectrum senolytics
In a dish and in mice. Ouabain made worn-out human cells more likely to die, partly by switching on a protein that tells cells to die. It cleared worn-out cells in mice that were old or had been given radiation, including cells on the way to becoming cancer.
Human cells in culture plus mice. Ouabain sensitised senescent cells to apoptosis, mediated in part by induction of the pro-apoptotic BCL-2 family protein NOXA, and eliminated senescent cells accumulating after irradiation and in old mice, including senescent preneoplastic cells.
- Lab (cells in a dish)2019Identification and characterization of Cardiac Glycosides as senolytic compounds
In a dish and in mice. These heart drugs killed worn-out human cells, probably by upsetting the charge and acid balance inside them. Paired with a drug that wears cells out first, they wiped out human tumours grown in mice and cut lung scarring. The paper has a published correction from 2020.
Human cells in culture plus mouse xenografts. Membrane depolarisation and intracellular acidification were proposed as the selectivity mechanism. A senescence-inducing plus senolytic combination eradicated xenografted tumours in mice and eliminated senescence-induced lung fibrosis. The paper carries an erratum published in 2020.
- Lab (cells in a dish)2021Ouabain and chloroquine trigger senolysis of BRAF-V600E-induced senescent cells by targeting autophagy
In a dish. Ouabain only killed worn-out cells when it sent a signal through the cell's salt pump. A drug that blocked the pump without sending the signal did not kill them.
Cell culture. Senolysis by ouabain required signal transduction through the sodium-potassium ATPase, not ion transport blockade alone: a pump inhibitor that blocked transport without triggering signalling was not senolytic.
- Lab (cells in a dish)2021Apoptosis resistance of senescent cells is an intrinsic barrier for senolysis induced by cardiac glycosides
In a dish, and it points the other way. The worn-out cells in this work were naturally resistant to dying, and that limited what these drugs could do. It is part of why this drug group is not a settled way to clear worn-out cells.
Cell culture, and it points the other way. Senescent cells in this work were intrinsically resistant to apoptosis in a manner that limited cardiac glycoside senolysis. Published alongside the 2019 findings, it is part of why this class is not a settled senolytic.
Common questions
Has Cardiac glycosides been tested in people?
Yes. 6,800 people given it across 1 completed trial cited here, 1 of which found nothing. Two 2019 papers said these heart drugs kill worn-out cells in a dish and in mice. Separately, digoxin was tested for heart failure in one of the biggest heart studies ever, in 6,800 people. That study did not look at worn-out cells. These are two different bodies of proof, and one does not carry over to the other.
What is the Cardiac glycosides dosage?
Approved medicine. No human dose established for unlabelled uses. Labeled amounts sit on the prescribing information. This page records what trials measured, not a personal dose. Digoxin is an FDA-approved prescription drug for heart failure and atrial fibrillation, a common irregular heartbeat. openFDA, the FDA's public drug database, lists current prescription products plus several discontinued ones. No drug in this family is approved anywhere to clear worn-out cells or for ageing. Ouabain is not sold as a medicine in the United States.
Is Cardiac glycosides FDA-approved?
Digoxin is an FDA-approved prescription drug for heart failure and atrial fibrillation, a common irregular heartbeat. openFDA, the FDA's public drug database, lists current prescription products plus several discontinued ones. No drug in this family is approved anywhere to clear worn-out cells or for ageing. Ouabain is not sold as a medicine in the United States.
Does digoxin clear senescent cells in people?
Nobody knows. No published study has measured worn-out cells in people after giving any of these drugs. One early study at the University of Leeds plans to measure it in blood vessel cells from fat tissue. As of September 2026 it had not started recruiting.
Does the big digoxin heart failure trial support taking it for ageing?
No. The big study took 6,800 people with heart failure and measured deaths and hospital stays. Deaths did not change. It measured nothing about worn-out cells, and it did not include healthy people.
Which cardiac glycoside is the senolytic in the papers?
Ouabain is the one named in the 2019 Nature Metabolism paper. Digoxin, digitoxin and proscillaridin A were described as doing the same thing. Ouabain is not sold as a medicine in the United States.
Is the senolytic finding disputed?
Partly. A 2021 paper found that worn-out cells can be naturally resistant to dying, which blocked these drugs from killing them. That points against the 2019 results. Both are in cells in a dish, and both are on this page.