Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
ACYLANID vs CEDILANID-D
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Acylanid is a cardiac glycoside that inhibits the Na+/K+-ATPase pump, leading to increased intracellular sodium and calcium concentrations, which enhances myocardial contractility.
Digitalis glycoside; inhibits Na+/K+-ATPase, increasing intracellular calcium and cardiac contractility.
Heart failure,Atrial fibrillation,Atrial flutter
Heart failure,Atrial fibrillation,Atrial flutter
0.1 mg IV bolus over 5 minutes, followed by 0.1 mg IV after 1 hour if needed; then 0.1-0.2 mg orally every 6-8 hours for maintenance. Maximum cumulative dose: 0.4 mg IV.
0.05 to 0.2 mg intravenously or intramuscularly, administered slowly over 5 minutes; initial dose 0.15 to 0.2 mg, then 0.1 to 0.15 mg every 30 minutes up to a total of 0.4 mg. Oral: 0.05 to 0.2 mg daily for maintenance.
Terminal half-life 33–36 hours (anuric patients up to 110 hours); requires dose adjustment in renal impairment.
Terminal elimination half-life is 36-48 hours in patients with normal renal function; prolonged to >100 hours in severe renal impairment, requiring dose adjustment.
Hepatic metabolism via hydrolysis and conjugation; not significantly metabolized by CYP enzymes.
Hepatic (minor); primarily renally excreted unchanged.
Renal (≈70% as unchanged drug), biliary/fecal (≈30%)
Renal excretion of unchanged drug accounts for 60-70% of elimination; biliary/fecal excretion accounts for 30-40%, with enterohepatic circulation present.
25–30% bound to albumin.
25-30% bound to plasma albumin.
7.5–10 L/kg; wide distribution indicating extensive tissue binding.
6-10 L/kg; large Vd indicates extensive tissue distribution and high cardiac tissue affinity.
Oral: 70–85% (variable, dependent on gastrointestinal absorption).
Oral: 70-80%; IV: 100%.
GFR <30 m L/min: reduce dose by 50% and extend dosing interval to every 12-24 hours. GFR 30-50 m L/min: consider 25% dose reduction. Monitor digoxin levels.
GFR <50 m L/min: reduce dose by 50% or extend dosing interval to every 36-48 hours. GFR <10 m L/min: avoid use or reduce dose by 75%.
Child-Pugh Class B: reduce dose by 25-50%. Child-Pugh Class C: use with caution, reduce dose by 50% and monitor levels. Not recommended in severe hepatic impairment.
Child-Pugh Class A: no adjustment. Child-Pugh Class B: reduce dose by 25-50%. Child-Pugh Class C: avoid use or reduce dose by 75%.
Loading dose: 10-15 mcg/kg IV over 5 minutes. Maintenance: 5-10 mcg/kg orally every 8-12 hours. Maximum daily dose: 250 mcg in children <2 years, 500 mcg in older children.
Digitalizing dose: 0.01-0.02 mg/kg IV or IM, given in divided doses over 24 hours. Maintenance: 10-20% of digitalizing dose daily. Not recommended for neonates due to prolonged half-life.
Initiate with 50% of usual adult dose due to reduced renal function and increased sensitivity. Maximum loading dose: 0.2 mg IV. Maintenance: 0.1 mg every 12 hours. Monitor electrolytes and ECG.
Reduce dose by 25-50% due to decreased renal function and increased sensitivity. Monitor serum levels and renal function closely.
None.
Can cause potentially fatal arrhythmias; use only when clearly indicated and monitor serum levels.
Risk of digitalis toxicity; monitor renal function and electrolytes; caution in hypokalemia, hypomagnesemia, and hypercalcemia.
Narrow therapeutic index; toxicity risk increased with hypokalemia, hypomagnesemia, hypercalcemia, renal impairment; monitor ECG and drug levels.
Ventricular fibrillation,Hypersensitivity to cardiac glycosides,Digitalis toxicity
Ventricular fibrillation, digitalis toxicity, hypersensitivity, AV block (unless pacemaker present), Wolff-Parkinson-White syndrome.
Avoid high-potassium foods (bananas, oranges, spinach) unless directed; hypokalemia increases toxicity. Take with food to reduce GI upset. Do not take with high-fiber meals as may reduce absorption.
Avoid licorice, which can cause hypokalemia. Maintain consistent intake of potassium-rich foods (bananas, oranges) to avoid fluctuations. No known significant food interactions beyond electrolyte effects.
Acylanid is a cardiac glycoside with limited data in pregnancy. First trimester: No specific malformations reported, but potential for fetal cardiac effects due to mechanism. Second and third trimesters: Maternal toxicity (arrhythmias, electrolyte disturbances) may cause fetal hypoxia or growth restriction. Avoid toxicity. Category C.
Pregnancy Category C. First trimester: No adequate human studies; animal studies show fetal risk. Second/third trimester: Risk of fetal bradycardia, cardiac glycoside toxicity; avoids if possible.
Acylanid is excreted into breast milk in low amounts (M/P ratio not established; estimated <1% of maternal dose). No adverse effects reported in nursing infants. Use with caution, monitor infant for bradycardia or arrhythmias.
Deslanoside is excreted in breast milk; estimated infant dose 0.1-0.5% of maternal weight-adjusted dose; M/P ratio not well defined. Monitor infant for bradycardia, feeding difficulties; benefit likely outweighs risk.
Increased volume of distribution and renal clearance in pregnancy may reduce serum levels; monitor drug levels and adjust dose to maintain therapeutic range (0.5-2 ng/m L). Start at lower doses if hypokalemia or preeclampsia present.
Increased renal clearance in pregnancy may require higher doses; monitor serum drug levels and adjust accordingly. Reduced dosing in third trimester may be needed due to volume expansion.
Acylanid (lanatoside C) is a digitalis glycoside with rapid onset (IV 10-30 min) and moderate duration; use in atrial fibrillation with rapid ventricular response, especially in acute settings. Monitor renal function due to renal elimination; toxicity risk increases with hypokalemia, hypomagnesemia, hypercalcemia. Adjust dose in renal impairment (Cr Cl <50 m L/min). Therapeutic drug monitoring: target serum level 0.5-2 ng/m L (drawn >6-8 hours post-dose).
Cedilanid-D (deslanoside) is a rapidly acting parenteral digitalis glycoside. Use with extreme caution in renal impairment due to reduced clearance. Monitor serum potassium and magnesium; hypokalemia and hypomagnesemia potentiate toxicity. Administer slow IV push over 5 minutes to avoid arrhythmias. Therapeutic drug monitoring less common due to short half-life of 33 hours. Contraindicated in ventricular tachycardia and AV block (unless due to atrial fibrillation).
Take exactly as prescribed; do not skip doses or double up. Missed dose: take if within 12 hours, otherwise skip.,Monitor for signs of toxicity: nausea, vomiting, diarrhea, visual disturbances (yellow-green halos, blurred vision), confusion, irregular heartbeat.,Avoid OTC medications without consulting prescriber, especially antacids, laxatives, and antiarrhythmics.,Keep regular appointments for blood tests (digoxin level, kidney function, electrolytes).,Report weight gain >2 lbs/day, swelling, shortness of breath, or palpitations.
Take exactly as prescribed; do not double doses.,Report symptoms of toxicity: nausea, vomiting, visual disturbances (yellow-green halos), irregular heartbeat.,Avoid over-the-counter medications without consulting doctor.,Maintain consistent potassium intake; avoid high-potassium foods or supplements unless advised.,Monitor daily weight and report rapid weight gain or edema.
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about ACYLANID vs CEDILANID-D, answered by our medical review team.
ACYLANID is a Cardiac Glycoside that works by Acylanid is a cardiac glycoside that inhibits the Na+/K+-ATPase pump, leading to increased intracellular sodium and calcium concentrations, which enhances myocardial contractility.. CEDILANID-D is a Cardiac Glycoside that works by Digitalis glycoside; inhibits Na+/K+-ATPase, increasing intracellular calcium and cardiac contractility.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between ACYLANID and CEDILANID-D depend on the specific clinical indication. These are both Cardiac Glycoside agents and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of ACYLANID is: 0.1 mg IV bolus over 5 minutes, followed by 0.1 mg IV after 1 hour if needed; then 0.1-0.2 mg orally every 6-8 hours for maintenance. Maximum cumulative dose: 0.4 mg IV.. The standard adult dose of CEDILANID-D is: 0.05 to 0.2 mg intravenously or intramuscularly, administered slowly over 5 minutes; initial dose 0.15 to 0.2 mg, then 0.1 to 0.15 mg every 30 minutes up to a total of 0.4 mg. Oral: 0.05 to 0.2 mg daily for maintenance.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between ACYLANID and CEDILANID-D in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. ACYLANID is classified as Category C. Acylanid is a cardiac glycoside with limited data in pregnancy. First trimester: No specific malformations reported, but potential for fetal cardiac effects due to mechanism. Secon. CEDILANID-D is classified as Category C. Pregnancy Category C. First trimester: No adequate human studies; animal studies show fetal risk. Second/third trimester: Risk of fetal bradycardia, cardiac glycoside toxicity; avo. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.