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Side effects

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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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