Neonatal Intensive Care Drug Manual

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).

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