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Risk Factors to Consider when Diagnosing Digoxin Toxicity

Which patients may be at higher risk for digoxin toxicity? Recognizing digoxin toxicity may be difficult, but it may help to know what to look for. Patients at risk of digoxin toxicity are typically older and have comorbidities.1

Risk factors for digoxin toxicity include1,2,3:

  • Advanced age (>80 years)
  • Decrease in renal clearance or loss of renal function due to chronic disease
  • Hypokalemia
  • Hypomagnesemia
  • Hypothyroidism
  • Multiple concomitant prescription drugs
  • Macrolide antibiotics
  • Drugs that impair renal function
  • Drugs that cause hypokalemia

When diagnosing digoxin toxicity, pay attention to these risk factors. Patients undergoing digoxin therapy who exhibit these risk factors should be closely monitored so that any signs of digoxin poisoning are identified early to ensure timely treatment.

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  1. Wofford JL, Ettinger WH. Risk factors and manifestations of digoxin toxicity in the elderly. Am J Emerg Med. 1991;9(suppl 1):11-15.
  2. Schreiber D. Toxicity, digitalis. eMedicine from WebMD Web site. Updated January 4, 2017. Accessed August 21, 2018.
  3. Gomes T, Mamdani MM, Juurlink DN. Macrolide-Induced Digoxin Toxicity: A Population-Based Study. Clinical Pharmacology & Therapeutics 2009;86(4):383-386.

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