Digoxin: Precautions, Side Effects, & Toxicity

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What is Digoxin?

Digoxin is a drug used to treat heart rhythm disturbances (arrhythmias), such as atrial fibrillation (AF). In addition, this drug can also be used to treat heart failure. Digoxin is available in tablet and injection form.

Digoxin is a cardiac glycoside drug that works by affecting several types of minerals, namely sodium and potassium in heart cells. This way of working will reduce the workload of the heart, help restore a normal and stable rhythm, and strengthen the heart rate.

Digoxin trademarks: Digoxin, Fargoxin.

Category Prescription drug (Antiarrhythmic)
Benefit Treating arrhythmias and heart failure
Used by Adults and children
Digoxin for pregnant and lactating women Category C: Animal studies have shown adverse effects on the fetus, but there have been no controlled studies in pregnant women.

Drugs should only be used if the expected benefit outweighs the risk to the fetus.

Digoxin is absorbed into breast milk. If you are breastfeeding, do not use this medicine without consulting to your doctor first.
Drug form Tablets and injection

Precautions Before Using Digoxin

Digoxin is a prescription drug that should not be used carelessly. There are several things to consider before undergoing treatment with digoxin, namely:

  • Tell your doctor about your history of allergies. Digoxin should not be given to patients who are allergic to this drug.
  • Do not immediately engage in activities that require alertness, such as driving a vehicle or operating heavy machinery after using digoxin, if this medicine causes dizziness and blurred vision in you.
  • Tell your doctor if you have or have had ventricular fibrillation, cardiomyopathy, cardiac amyloidosis, pericarditis, arrhythmias due to certain heart medications, or atrioventricular block, especially if you have a history of Stokes-Adams syndrome.
  • Consult a doctor about the use of digoxin in the elderly and children to avoid the risk of serious side effects.
  • Tell your doctor if you have or are currently suffering from a heart attack, sick sinus syndrome, myocarditis, kidney disease, thyroid disease, respiratory distress, vascular disorder, or malabsorption syndrome.
  • Tell your doctor if you have ever had an electrolyte imbalance, especially hypokalemia, hypocalcemia, hypercalcemia, or hypomagnesaemia.
  • Tell your doctor that you are taking digoxin before having surgery or certain medical procedures, including heart surgery.
  • Tell your doctor if you are taking any other medications, including supplements and herbal products, to anticipate drug interactions.
  • Tell your doctor if you are pregnant, breastfeeding, or planning a pregnancy.
  • Do not consume alcoholic beverages while on treatment with digoxin, as this can increase the risk of side effects.
  • Drink enough water and avoid dehydration during treatment with digoxin to prevent the risk of side effects.
  • See your doctor right away if you have an allergic drug reaction, serious side effect, or overdose after using digoxin.

Digoxin Side Effects and Dangers

Side effects that may arise after using digoxin are:

  • Vomit
  • Loss of appetite
  • Nauseous
  • Headache
  • Body feels weak or dizzy
  • Diarrhea
  • Anxiety
  • Depression

See your doctor right away if you have an allergic reaction to a medication, or a more serious side effect, such as:

  • Stomach ache
  • Irregular heartbeat
  • Dizzy like I’m about to faint
  • Bloody or black stools and thick texture
  • Daze or hallucinations
  • Pain or swelling in the breast
  • Enlarged breasts in men (gynecomastia)
  • Blurred vision or yellowing vision
  • Sudden mood swings

In infants and children, digoxin can cause serious side effects such as stomach ache, weight loss, slowed height gain, and behavioral changes. Immediately consult a pediatrician if these side effects occur in your child.

Digoxin Overdose

Also known as digoxin toxicity or digoxin poisoning is a type of poisoning that occurs when people take too much of the medication digoxin or eat plants that contain a similar substance, such as foxglove.

Toxicity may occur quickly after an overdose or gradually over time during long-term treatment.

Symptoms of digoxin overdose typically vague such as vomiting, loss of appetite, confusion, blurred vision, color perception changes, and decreased energy. In addition, an irregular heartbeat, which can be either too fast or too slow, is one of the potential complications.

How to Use Digoxin Properly?

Digoxin injection will be given directly by a doctor or medical officer under the supervision of a doctor.

If you are prescribed digoxin tablets, follow your doctor’s advice and read the information on the medicine package before starting to take it. Do not increase or decrease the dose without consulting your doctor first.

Digoxin tablets can be taken before or after meals. Swallow the tablet with water.

If you forget to take digoxin tablets, take them immediately if you are not close to the next schedule for taking the drug. If it is close, ignore the missed dose and do not double the dose on the next schedule of consumption.

Follow the control schedule that has been given by the doctor. While on treatment with digoxin, you may be asked to have regular complete blood tests, or kidney function tests, performed.

If possible, check your blood pressure and pulse daily using a blood pressure monitor at home while taking digoxin. Consult a doctor if your pulse or blood pressure is too low.

Store digoxin in a dry place and away from direct sunlight. Keep medicine out of reach of children.

References:

  • Kinsley, et al. (2021). A Case of Digoxin Toxicity Due to Acute Renal Failure. Cureus, 12 (8), pp. e17599.
  • National Health Service UK (2020). Medicines A to Z. Digoxin.
  • Mayo Clinic (2022). Drugs and Supplement. Digoxin (Oral Route).
  • Electronic Medicine Compendium (2020). Digoxin Tablets BP 125 micrograms.
  • Healthline (2018). Digoxin, Oral Tablet.
  • Medscape (2022). Digoxin (Rx).
  • Verywell Health (2022). What to Know About Digoxin.
  • WebMD (2022). Digoxin – Uses, Side Effects, and More.

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