Digoxin toxicity may be caused by one or more of the following:

• Taking too much digoxin (overdosing).

• Taking substances that contain foxglove or lily of the valley.

• Taking digoxin on a regular basis.

• Having certain conditions, such as dehydration or worsening heart failure.

• Taking another medicine that raises digoxin levels in your body.

• Having low potassium or magnesium levels.

• Having reduced kidney function.

Symptoms of this condition may include:

• Confusion.

• Changes in your vision, such as:

  • Seeing the color yellow or green more than you normally do.

  • Blurred vision.

  • Increased sensitivity to light.

  • Seeing flashing lights.

• Headaches.

• Irregular heartbeat that may be too fast or too slow (arrhythmia).

• Weakness or fatigue.

• Loss of appetite.

• Nausea or vomiting.

• Diarrhea.

This condition may be diagnosed based on your symptoms and a physical examination. You may also have tests, such as:

• Blood tests.

• An electrocardiogram (ECG). This test records the electrical impulses of your heart.

To lower your digoxin levels, your health care provider may do one or more of the following:

• Give you medicine that absorbs digoxin in the stomach, such as activated charcoal. This may be given orally or through a tube that goes from your nose to your stomach (nasogastric tube).

• Perform gastric lavage. In this procedure, a tube is placed through your nose or mouth into your stomach. The tube is used to remove digoxin that has not yet been absorbed. It may also be used to put medicines directly into your stomach to help stop digoxin from being absorbed.

• Give you a medicine called digoxin immune fab through an IV. This binds digoxin that has been absorbed and is in your body’s cells.

Eating and drinking

• Follow instructions from your health care provider about eating or drinking restrictions.

• Talk to your health care provider about your diet. The amount of fiber that you eat may affect how well your digoxin medicine works.

• Tell your health care provider if you drink caffeine or alcohol, smoke, or use drugs. This may affect the way your digoxin medicine works.

• Do not drink alcohol if:

  • Your health care provider tells you not to drink.

  • You are pregnant, may be pregnant, or are planning to become pregnant.

• If you drink alcohol:

  • Limit how much you have to:

    • 0–1 drink a day for women.

    • 0–2 drinks a day for men.

  • Know how much alcohol is in your drink. In the U.S., one drink equals one 12 oz bottle of beer (355 mL), one 5 oz glass of wine (148 mL), or one 1½ oz glass of hard liquor (44 mL).

• Drink enough fluid to keep your urine pale yellow.

General instructions

• Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

• If you had tests done, it is up to you to get the results. Ask your health care provider, or the department that is doing the tests, when your results will be ready.

• Keep all follow-up visits. This is important.

You can help prevent digoxin toxicity from happening again by doing the following:

• Take your digoxin medicine exactly as directed. Try to take it at regular intervals.

  • If you miss a dose, take it as soon as you can, unless it is almost time to take your next dose. In that case, only take that one dose as normal. Do not take two doses at the same time.

  • Do not take your medicine more often than directed.

  • Take your medicine with a glass of water.

• Take over-the-counter and prescription medicines only as told by your health care provider.

• Check with your health care provider before stopping or starting any medicines.

• Do not take antacids unless your health care provider approves.

• Do not take over-the-counter medicines for pain, allergies, coughs, or colds unless your health care provider says it is okay.

• Tell all health care providers that you are taking digoxin.

• Keep a list of all the medicines you take, including over-the-counter medicines, nutritional supplements, and herbal products. Bring this list with you to all of your medical visits.

• Read the drug inserts that come with your medicines.

• Check your heart rate and blood pressure regularly. Ask your health care provider what your heart rate and blood pressure should be and when you should seek medical care.

• Have your digoxin, potassium, and magnesium levels checked regularly.