Digoxin Toxicity

Digoxin is a medicine that can help a weakened heart to function properly. Digoxin increases the strength of the heart muscle, helps to maintain a normal heart rhythm, and helps to remove excess water from the body. When there is too much digoxin in the body, it acts like a poison (toxin). This condition is called digoxin toxicity.

CAUSES

Digoxin toxicity can occur due to an accidental overdose. It can also occur if you are taking the correct amount of digoxin but there are other factors affecting the digoxin levels in your body. These factors can include:

  • Taking other medicines that interact badly with digoxin.

  • Having low potassium or magnesium levels.

  • Having reduced kidney function. This prevents digoxin from leaving your body at the normal speed.

SYMPTOMS

  • Confusion.

  • Changes in color vision (seeing more yellow color), blurred vision, increased sensitivity to light, or seeing flashing lights.

  • Irregular heartbeats (palpitations). These heartbeats may be too fast or too slow.

  • Loss of appetite, nausea, vomiting, or diarrhea.

DIAGNOSIS

Blood tests may be done to check your digoxin, potassium, and magnesium levels. Electrocardiography may also be done to record the electrical activity of your heart.

TREATMENT

Digoxin toxicity is treated in the hospital. To lower your digoxin levels, you may be given a medicine called activated charcoal. Your caregiver may also perform gastric lavage. In this procedure, a tube is inserted through the mouth and into the stomach to clean out the stomach.

PREVENTION

The following instructions can help prevent digoxin toxicity:

  • Take your digoxin medicine exactly as prescribed. If you miss a dose, take it as soon as you can. If it is nearly time for your next dose, take only that 1 dose. Do not take 2 doses at the same time.

  • Swallow your digoxin medicine with water. It is best to take digoxin on an empty stomach, at least 1 hour before a meal or 2 hours after a meal.

  • Take your digoxin doses at regular intervals. Do not take your medicine more often than directed.

  • Tell your caregiver about all other medicines you are taking, including over-the-counter medicines, nutritional supplements, or herbal products.

  • Check with your caregiver before stopping or starting any medicines.

  • Do not take antacids or over-the-counter medicines for pain, allergies, coughs, or colds without your caregiver's permission.

  • Tell your caregiver if you drink caffeine or alcohol, you smoke, or you use street drugs. This may affect the way your digoxin medicine works.

  • Talk to your caregiver about your diet. The amount of fiber you eat may affect the way your digoxin medicine works.

  • If you are going to have surgery, tell your surgeon that you are taking digoxin.

HOME CARE INSTRUCTIONS

  • Check your heart rate and blood pressure regularly. Ask your caregiver what your heart rate and blood pressure should be and when you should contact him or her.

  • Keep all follow-up appointments as directed by your caregiver. You may need to have additional and blood tests electrocardiography.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop chest pain or shortness of breath.

  • You have fainting spells or a fast, irregular heartbeat.

  • You have a slow heartbeat (less than 50 beats per minute).

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.