Good afternoon Dr Shraddha ,

Digoxin is cardiotonic that means it increases the force of contraction of heart muscles,

this drug acts by increasing Ca concentration inside heart muscles.

but the bad thing about this drug is it is associated with some serious side effects that is called digoxin toxicity, ( nausea , vomiting, weakness, bradycardia, conduction block )

this drug has a long half-life hence it can accumulate in blood if consumed in long run, hence this drug is advised 5 days in week.

about replacement to this drug in Ayurveda yes we do have strong cardiotonic like arjuna which is there in HFRT treatment and our cardiac range of prescription.

you can refer to this paper for further details.

http://www.iosrjournals.org/iosr-jdms/papers/Vol7-issue2/M0724851.pdf

about precautions other than a fluid restriction

yes we need to consider the following points too

1.  minimizing sympathetic activation by Yoga and respiratory exercises like bhramary , anulom vilom and chandranuloma ,
2. assessing liver function and accordingly using liver tonics like Linolive  or Aloori as per need.
3. decide whether liquid or semiliquid or solid food is good based on patients’ feedback to diet chart .
4. use M vita to provide micronutrition.
5. monitor weight periodically to assess fluid retention
   monitor steps per day
   monitor abdominal girth
6. monitor NT probnp
7. monitor EDV on 2 d echo monthly for the first 3 months and then once in 6 months
8. don’t forget to check for Hb in case of heart failure

if you follow all these guidelines properly then you can easily improve patients of heart failure with our therapy.