Digoxin may worsen arrhythmias (proarrhythmic effect).
Digoxin has a narrow therapeutic range; adverse effects are related to its plasma concentration and very few occur at <0.8 microgram/L (1 nmol/L).
Digoxin usually has an effect on the ECG and may result in prolonged PR interval, ST depression or T wave inversion (these changes do not necessarily indicate digoxin toxicity or myocardial ischaemia).
In children, arrhythmias (including sinus bradycardia) are the earliest and most frequent indicators that digoxin dosage is too high.
Common (>1%): Anorexia, nausea, vomiting, diarrhoea, visual disturbances (e.g. blurred vision), drowsiness, dizziness, headache, rash, bradycardia, arrhythmia
Infrequent (0.1–1%): Depression, shortened QRS complex, atrial or ventricular extrasystoles, paroxysmal atrial tachycardia with AV block, ventricular tachycardia or fibrillation, heart block.
Rare (<0.1%): Thrombocytopenia, seizures, confusion, psychosis, gynaecomastia (long-term use).
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Compatibility
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Fluids: Glucose 5%, Hartmann’s, sodium chloride 0.9%.
Y-site: Anidulafungin, bivalirudin, ceftaroline fosamil, ceftobiprole medocaril, ciprofloxacin, cisatracurium, dexmedetomidine, heparin sodium, hydrocortisone sodium succinate, levosimendan, linezolid, midazolam, milrinone, morphine sulfate, pethidine, potassium chloride, remifentanil
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