Digoxin Toxicity

May 29, 2008

Digoxin toxicity has always been a major problem, due to the narrow range separating medically-effective digoxin levels from toxic levels of the drug. Now, with the recent mislabeling and mispackaging of digoxin that led to people being given digoxin doses equivalent to twice their prescribed dosage, and the subsequent recall, many people are concerned with digoxin toxicity.

Diagnosing Digoxin Toxicity

Digoxin toxicity is responsible for many nonspecific symptoms, making it very difficult to diagnose.These symptoms include:

· Visual changes, such as halos, unfocused vision, changes in color vision, even hallucinations

· Lethargy or drowsiness

· Confusion or euphoria

· Headaches

· Nausea and vomiting

· Diarrhea

· Abdominal pain

Toxicity can take minutes or hours to become evident. Acute toxicity generally manifests itself with nausea, vomiting, and lethargy, while chronic toxicity is usually signaled by visual changes, but can be very difficult to diagnose. The only way to actually diagnose digoxin toxicity is with blood tests.

Influences on Toxicity Levels

Unfortunately, digoxin can often be made more toxic by other factors in your body. This includes:

· High or low mineral levels, including elevated potassium or calcium levels, or depressed potassium or magnesium levels

· Kidney disease

· Hypothyroidism

· Low blood oxygen levels

· High blood pH

· Other medications, including:

o Beta-blockers, calcium channel blockers, and other medications that affect your mineral levels

o Diuretics

o Antibiotics such as tetracycline that inactivate bacteria that can inactivate digoxin

These risk factors can dramatically affect the level of digoxin in your bloodstream, making it more likely that you will suffer digoxin toxicity with a lower dose.

Digoxin Resilience

In addition to digoxin’s narrow therapeutic range and its susceptibility to other factors in your body, another element that makes digoxin toxicity so dangerous is that digoxin tends to stay in your body for a long period of time after your toxic exposure.

Digoxin has what is known as a relatively long biological half-life. Biological half-life is the amount of time it takes for a drug or other substance in your body to lose half of its effect. This depends on the volume of blood in your body and the ability of your kidneys to filter the drug from your bloodstream. A normal half-life for digoxin ranges from 24-36 hours in a person with healthy kidneys.

However, because you were prescribed digoxin for regulating a dangerous heart condition, you cannot simply stop the medication once you realize you may have received twice your dosage, or you will experience a period in which you are exposed to the even greater danger of your heart condition. Instead, you will have to take your digoxin at the lower dosage and allow your body to stabilize the level of the drug in your blood, which usually takes about 4.7 times the biological half-life, or a week or more.

In addition, because chronic digoxin toxicity is difficult to diagnose, and occurs frequently without being detected, you may have been suffering from digoxin toxicity for a long time, but only detected it as a result of the Actavis error. In this case, you will need to be evaluated for chronic toxicity, and it may take much longer for your digoxin levels to regulate.

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Comments

6 Responses to “Digoxin Toxicity”

  1. theresa walsh on August 30th, 2008 3:15 pm

    i was on digiteck for my irregular heart beat when they had the recall the dr put me on digioxn is this also bad for me

  2. Lora White on March 15th, 2009 2:55 am

    Digoxin can cause lung problems. My husband has heart failure and kidney failure but he almost died from lung failure and after a month in ICU a nephrologist made the connection. Upon stopping the Digoxin my husband recovered within 3 days.

  3. gale moys on May 5th, 2009 8:49 pm

    i had open heart surgery 2001, because I was born with two buckles in my heart. And I also had a irregular heart before and after the surgery. I was on digoxin,then digitek an nw back on digoxin. Is the digoxin safe or not. Please let me know my heart doctor has not taken me off. So, I’m sure if it was not he would have taken me off.

    Thanks

  4. » Blog Archive » Digitek Recall and Digitek Side Effects on May 27th, 2009 4:06 pm

    [...] However, like most medications, Digitek has a host of potentially severe side effects.  The rate at which these side effects occur increases as the dosage of the drug increases.  Thus, when the makers of Digitek erred by mislabeling and mispackaging the drug so that patients were given much more than their prescribed dosage, many patients experienced negative side effects.  This error led to the Digitek recall. [...]

  5. A Carlton III on October 5th, 2009 11:23 am

    I have ESRD and CHF and was taking Digitek. I have no clue if I have been affected by any of the side effects so does anyone know how I can be tested for any of the side effects?

  6. Victoria on November 18th, 2009 5:38 pm

    I was recently put on Digitek for my heart .However I have had some reactions to it that made me wonder why would anyone be put on an medicine that caused the reactions I had. My skin smelled like it was burning, I was seeing halos in my eyes.I caused me to have sharp shooting pains in my head.

    My throat felt like it was closing up on me .I stopped taking it, No sooner I did. I had an overwhelming feeling that I was going to paas out…I felt confused not sure of myself…

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