Nakada's synthesis of digitoxigenin

Digitoxin and digoxin make up the drug digitalis, which is used as a cardiac drug to treat cardiac congestion and cardiac arrythmias. The mechanism within the heart involves increasing intracellular Na⁺ and Ca²⁺ while decreasing intracellular K⁺. The increased Ca²⁺ promotes muscle contraction and cardiac contractile force. Digitalis has also been reported to exhibit anti-cancer activity.

A glycoside consists of part sugar and part nonsugar. The sugar portion is called the glycone and the nonsugar portion is called the aglycone, or genin. Digitoxigenin is the aglycone of digitoxin. The R group of digitoxigenin is what defines the class of cardiac drug.