Digoxin is still useful, but is still causing toxicity.

Cleve Clin J Med · Aug 2024

Review

Digoxin is still useful, but is still causing toxicity.

Digoxin, the oldest known cardiovascular drug, is still used today to treat heart failure and atrial fibrillation. Because it has a narrow therapeutic index and multiple interactions, it frequently causes toxicity with a wide range of symptoms and cardiac arrhythmias. More importantly, elevated serum digoxin levels have been linked to a higher risk of death in patients with heart failure or atrial fibrillation, even without signs or symptoms of toxicity. This article reviews the current state of digoxin use, its pharmacologic principles, and the mechanisms, clinical presentation, and management of toxicity.

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- Alejandro Durán Crane, Michael Militello, and Michael D Faulx.
- Cardiovascular Medicine Fellow, Cleveland Clinic, Cleveland, OH.
- Cleve Clin J Med. 2024 Aug 1; 91 (8): 489499489-499.
AbstractDigoxin, the oldest known cardiovascular drug, is still used today to treat heart failure and atrial fibrillation. Because it has a narrow therapeutic index and multiple interactions, it frequently causes toxicity with a wide range of symptoms and cardiac arrhythmias. More importantly, elevated serum digoxin levels have been linked to a higher risk of death in patients with heart failure or atrial fibrillation, even without signs or symptoms of toxicity. This article reviews the current state of digoxin use, its pharmacologic principles, and the mechanisms, clinical presentation, and management of toxicity.Copyright © 2024 The Cleveland Clinic Foundation. All Rights Reserved.

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Digoxin is still useful, but is still causing toxicity.

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