Digoxin Precautions and Warnings

Specific Precautions and Warnings With Digoxin

Some warnings and precautions to be aware of prior to taking this drug include the following:
  • Digoxin lowers heart rate and, in some cases, it may lower it too much. Your healthcare provider may advise you to measure your heart rate, by taking your pulse, before each digoxin dose. It is generally recommended that people skip their digoxin dose and contact their healthcare provider if their pulse is less than 60 beats per minute. Ask your healthcare provider about taking your pulse before each digoxin dose.
  • Although digoxin is used to treat a heart rhythm problem, in some cases it can cause other potentially serious arrhythmias. People with certain heart conditions may have an increased risk for developing arrhythmias while taking digoxin.
  • Certain heart conditions may increase your sensitivity to the effects of digoxin, increasing the risk for potentially serious side effects. Tell your healthcare provider your complete medical history before you begin digoxin treatment.
  • People with beriberi heart disease (heart disease associated with thiamine deficiency) may not respond as well to digoxin, unless the thiamine deficiency is also treated.
  • The kidneys remove the majority of digoxin from the body. If you have kidney disease, you may need lower digoxin doses.
  • An imbalance of certain blood electrolytes alters the way digoxin works in the body. Low blood potassium (hypokalemia) or magnesium levels (hypomagnesemia), or high calcium levels (hypercalcemia), may increase your risk for digoxin toxicity. Low calcium levels (hypocalcemia) can make digoxin ineffective.
Your healthcare provider will periodically check your electrolyte levels with a simple blood test during digoxin treatment. Also, let your healthcare provider know if you are sick and experience vomiting or diarrhea, as this may affect your blood electrolytes.
  • Tell your healthcare provider if you have thyroid problems (an underactive or overactive thyroid), as these conditions may alter the way your body responds to digoxin.
  • Make sure your healthcare provider knows you are taking digoxin before you have surgery or any medical procedure, including electrical cardioversion.
  • Digoxin is a pregnancy Category C medication. This means that it may not be safe for use during pregnancy (see Digoxin and Pregnancy).
  • Digoxin passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to beginning treatment (see Digoxin and Breastfeeding).
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