Patient/caregiver was educated on precautions to be exercised while taking digoxin as follows:
- In individuals using digoxin, the risk for toxicity with digoxin is quite high, as the therapeutic and toxic levels of digoxin in the blood are very close. Altered levels of calcium, potassium and magnesium ions in the blood can also contribute to increasing risk for digoxin toxicity and arrhythmias. Individuals with digoxin toxicity can present with severe nausea, vomiting, abdominal pain, appetite changes, headache, dizziness, confusion, and yellowing of vision. Individuals can also present with life-threatening arrhythmias, with associated chest pain, pounding irregular heartbeat, palpitations, dizziness, and exacerbated shortness of breath. Report any of these findings to your physician, during intake of digoxin, for any appropriate changes to be made on dose of digoxin and plan of care.
- Digoxin is minimally metabolized in the liver to active metabolites, which along with the significant unmetabolized portion of the drug is eliminated by kidneys in the urine. If renal function is deficient, the elimination of these compounds could be compromised. This can lead to increased blood levels of the medication and metabolites for longer periods of time, resulting in increased risk for side-effects and consequent toxicity with digoxin. So, in individuals with history of compromised renal function, digoxin must be used with extreme caution, closely monitored dose adjustments, periodical monitoring for renal functions and development of any toxicity symptoms with the medication. Observe close compliance with any labs ordered for renal function evaluation, while taking digoxin.
