Digoxin side effects

List of side effects
Overview Cardiac Gastrointestinal CNS Other

Overview
The frequency and severity of adverse reactions to Digoxin depend on the dose and route of administration, as well as on the patient's underlying disease or concomitant therapies. The overall incidence of adverse reactions has been reported as 5 to 20%, with 15 to 20% of them being considered serious (one to four percent of patients receiving Digoxin). Evidence suggests that the incidence of toxicity has decreased since the introduction of the serum Digoxin assay and improved standardization of Digoxin tablets. Cardiac toxicity accounts for about one-half, gastrointestinal disturbances for about one-fourth, and CNS and other toxicity for about one-fourth of these adverse reactions. Return to top

Cardiac
Conduction disturbances or supraventricular tachyarrhythmias, such as atrioventricular (AV) block, atrial tachycardia with or without block and junctional (nodal) tachycardia are the most common arrhythmias associated with Digoxin toxicity in children. Ventricular arrhythmias, such as unifocal or multiform ventricular premature contractions, especially in bigeminal or trigeminal patterns, are less common. Ventricular tachycardia may result from digitalis toxicity. Sinus bradycardia may also be a sign of impending Digoxin intoxication, especially in infants, even in the absence of first degree heart block. Any arrhythmias or alteration in cardiac conduction that develops in a child taking Digoxin should initially be assumed to be a consequence of Digoxin intoxication. Return to top

Gastrointestinal
Anorexia, nausea, vomiting and diarrhea may be early symptoms of overdosage. However, uncontrolled heart failure may also produce such symptoms. Return to top

CNS
Visual disturbances (blurred or yellow vision), headache, weakness, apathy and psychosis can occur. These may be difficult to recognize in infants and children. In one reported case, asymmetric chorea was seen at high Digoxin levels, and reappeared when similar levels were inadvertently re-achieved. Return to top

Other
Gynecomastia is occasionally observed. Return to top