Int J Clin Pharmacol 12 (1975): 89-95 van der Vijgh WJF, Oe PL "Pharmacokinetic aspects of digoxin in patients with terminal renal failure IV: clinical implications of own observations with a recent review of literature." There appears to be a gradual contraction in the volume of distribution as renal function deteriorates. Hypersensitivity.
When treated with digoxin, patients with preexisting sinus node disease may develop severe sinus bradycardia or sinoatrial block, and patients with incomplete AV block may progress to advanced or complete heart block. Specifically, the apparent volume of distribution and renal elimination of the drug may be increased, resulting in lower serum concentrations. Use caution in chronic constrictive pericarditis, electrical cardioversion, severe bradycardia, severe heart failure, severe pulmonary disease, sick sinus syndrome, ventricular tachycardia, ventricular premature contractions, Wolff-Parkinson-White syndrome, electrolyte imbalance, hypothyroidism or … Treatment with digoxin should be used with caution in these patients.Major Potential Hazard, High plausibility. Applies to: Renal DysfunctionDigoxin is primarily eliminated by the kidney. Cautions. Therapy with digoxin should be administered cautiously in patients with impaired renal function. In the U.S., 1 in every 4 deaths is caused by heart disease.What Are Side Effects Associated with Using Digoxin? In patients with hypokalemia or hypomagnesemia, digoxin toxicity may occur despite serum drug concentrations below 2.0 ng/mL. Therapy with digoxin should be administered cautiously in these patients.Moderate Potential Hazard, High plausibility. Recommendations regarding the use of digoxin in the management of heart failure or … Therefore, extreme caution is necessary when dosing patients with renal failure. Major Potential Hazard, High plausibility.
Allopurinol has a renally excreted active metabolite that accumulates in renal impairment and may cause adverse effects if the dose is not adjusted. Copyright © 2018 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment. Therapy with digoxin should be administered cautiously in such patients.
Applies to: CardiomyopathyDigoxin can rarely precipitate vasoconstriction and may promote the development of cytokines; therefore, should be avoided in patients with myocarditis.Major Potential Hazard, High plausibility. Applies to: HypothyroidismHypothyroidism may reduce the requirements for digoxin due to decreased volume of distribution and plasma clearance of the drug.
Serum digoxin levels should be monitored regularly and dosage adjustments may be required secondary to changes in thyroid condition.Moderate Potential Hazard, Moderate plausibility.
Therapy with digoxin should be administered cautiously in patients with hyperthyroidism. The drug may be ineffective in hypocalcemic patients until serum calcium levels are restored to normal. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Hypercalcemia should be corrected prior to initiating treatment with digoxin, and serum calcium levels should be monitored during therapy.Major Potential Hazard, High plausibility.
Electrolyte imbalances should be corrected prior to initiation of treatment.
Applies to: Preexcitation SyndromeDigoxin may enhance accessory pathway conduction in conditions such as the Wolff-Parkinson-White syndrome. Serum potassium and magnesium concentrations should be monitored during therapy.Major Potential Hazard, High plausibility.
Serum digoxin levels should be monitored regularly and dosage adjustments may be required secondary to changes in their thyroid condition.Moderate Potential Hazard, High plausibility. Applies to: Myocardial InfarctionThe use of inotropic drugs in some patients with acute myocardial infarction may lead to increases in myocardial oxygen demand and lead to ischemia. Digoxin may be administered to patients with complete, stable AV block who have congestive heart failure, provided the block was not induced by cardiac glycosides.Major Potential Hazard, High plausibility.