Side effects
Old patients are especially at risk of developing digoxin toxicity and therefore should be commenced on a low dose. There is an increased risk of toxicity in hypokalaemia and renal failure. Blood levels should be measured regularly.
Possible side effects include:
- arrhythmia: the most common arrhythmias are ventricular extrasystoles, ventricular bigemny / trigemny and atrial tachycardia with complete heart block
- anorexia, nausea and vomiting and occasionally, diarrhoea
- confusion especially in the elderly
- yellow vision, blurred vision and photophobia
- gynaecomastia
If patient becomes toxic then stop digoxin, treat any arrhythmias and check potassium. Secretion of digoxin can be increased by using digoxin-specific antibodies.
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