Symptoms of Digoxin Toxicity
The symptoms of digoxin toxicity range from obvious to non-specific. Obvious signs of digoxin poisoning may include vomiting, nausea, hypotension, or hypothyroidism.1 It can be difficult to recognize digoxin toxicity in patients, however, since the symptoms may be attributed to the underlying condition for which digoxin is prescribed.1
Signs and symptoms of life-threatening or potentially life-threatening digoxin toxicity include but are not limited to2,3:
- Severe ventricular arrhythmias
- Including sinus ventricular tachycardia or fibrillation
- Progressive bradycardia
- Second- or third-degree heart block not responsive to atropine
- Serum potassium levels exceeding 5.5 mEq/L in adults or 6 mEq/L in children with rapidly progressive signs and symptoms of digoxin toxicity
- Neurologic symptoms (eg, visual disturbances, disorientation, and confusion)
Diagnosing digoxin toxicity can also be difficult because about 30% of patients with digoxin toxicity have no symptoms.4 It may be helpful to know who's at risk for digoxin toxicity and the side effects of digitalis treatment to facilitate proper diagnosis.
To report an adverse event or for 24-hour medical information, call 1-844-293-0007.References
- Ma G, Brady WJ, Pollack M, Chan TC. Electrocardiographic manifestations: digitalis toxicity. J Emerg Med. 2001;20:145-152.
- DigiFab® [prescribing information]. BTG International Inc. January 2012.
- Schreiber D. Toxicity, digitalis. eMedicine from WebMD Web site. http://emedicine.medscape.com/article/814404-print. Updated December 2, 2009. Accessed June 11, 2010.
- Marik PE, Fromm L. A case series of hospitalized patients with elevated digoxin levels. Am J Med. 1998;105:110-115.
DigiFab® Digoxin Immune Fab (Ovine) is indicated for the treatment of patients with life-threatening or potentially life-threatening digoxin toxicity or overdose. DigiFab® is not indicated for milder cases of digitalis toxicity.
Important Safety Information
Patients with poor cardiac function may deteriorate secondary to the withdrawal of the inotropic action of digoxin by DigiFab®. Rapid drop in serum potassium concentration may occur after treatment with DigiFab®. Patients with known allergies to sheep protein, papaya, or papain are at higher risk of an anaphylactic reaction. Suicidal ingestion may involve more than one drug. Toxic effects of other drugs or poisons should not be overlooked. The most common adverse reactions (>7%) related to DigiFab® are worsening congestive heart failure (13%), hypokalemia (13%) and worsening atrial fibrillation (7%). Please see full prescribing information, including events, precautions, or warnings.