Patient education: Digoxin toxicity (The Basics)

What is digoxin? — Digoxin is a medicine used to treat certain heart problems. It might also be called "digitoxin" or "digitalis."

What is digoxin toxicity? — Digoxin toxicity happens when you have too much digoxin in your body. It can also happen when something else in your body makes the effects of digoxin more intense.

What causes digoxin toxicity? — Digoxin toxicity can be caused by:

●Taking too much digoxin, either by accident or on purpose

●The kidneys not working properly to filter digoxin out of the blood

●Taking other medicines that interfere with digoxin, such as certain heart medicines or antibiotics

●Losing a lot of fluid, such as through vomiting or diarrhea

If you take digoxin, there are some things that increase your risk of toxicity. These include:

●Older age

●Having kidney problems

●Not taking your medicines as instructed

●Not having not enough of certain "electrolytes," such as potassium and magnesium – This can increase the effects of digoxin on your heart.

What are the symptoms of digoxin toxicity? — Symptoms can include:

●Slow or irregular heartbeat

●Feeling lightheaded or dizzy, passing out, or having low blood pressure

●Stomach problems – These can include belly pain, nausea, vomiting, or losing your appetite.

●Feeling confused, weak, or very tired

●Vision problems – These can include changes to color vision, seeing double, sensitivity to light, seeing less clearly, seeing "floaters," blind spots, or blindness.

Should I see a doctor or nurse? — If you think that you or someone else took too much digoxin, call the Poison Control Center. In the US, the phone number is 1-800-222-1222. See a doctor or nurse, or go to the emergency department, if the Poison Control Center tells you to.

Will I need tests? — Yes. The doctor or nurse will learn about your symptoms and do an exam. Then, you will likely have these tests:

●Blood tests – These include tests to find out how much digoxin is in your blood. Your doctor will also order blood tests to check your electrolytes and how well your kidneys are working.

●Electrocardiogram ("ECG") – This test records your heart rate (how fast it beats) and rhythm. It does this by measuring the electrical activity in the heart.

You might also need other tests depending on your symptoms.

How is digoxin toxicity treated? — Treatment is given in the hospital. Your doctor or nurse will start by making sure that you can breathe properly. They will also put in an "IV," which is a thin tube that goes into a vein. The IV can be used to give you fluids or other medicines.

The other treatments you get depend on your symptoms and how severe they are. Treatments can include:

●"Fab fragments" – These are an antidote to digoxin. They are given by IV. They work by attaching to the digoxin and keeping it from affecting your body.

●Medicines to bring your heart rate back up

●Activated charcoal – This can help prevent any digoxin in your stomach from entering your blood.

●Fluids and electrolytes

Can digoxin toxicity be prevented? — There are some things you can do lower your chances of having digoxin toxicity:

●Follow your doctor or nurse's directions for taking your digoxin and checking your digoxin levels.

●Tell your doctor or nurse about any other medicines you are taking. Tell them if you start taking a new medicine, including over-the-counter or herbal medicines. Tell your doctor or nurse if you have any of the symptoms of digoxin toxicity.

●Tell any new doctor or nurse that you are taking digoxin. This way, they can check your level if you are feeling unwell.

More on this topic

Patient education: Medicines after a heart attack (The Basics)
Patient education: Medicines for heart failure with reduced ejection fraction (The Basics)
Patient education: Medicines for atrial fibrillation (The Basics)
Patient education: Medication safety (The Basics)
Patient education: Why taking your medicine as prescribed is important (The Basics)