Cardiovascular diseases account for 25% of all deaths in the US. The conditions are responsible for more than 650,000 fatalities in the US annually. Among the various medications in use for treatment for different types of cardiovascular diseases, Digoxin is effectively the oldest medication in use, tracing its roots to as early as the 1250s when cardiac glycosides were prescribed for treatment. While the drug has the reputation of being one of the oldest, side effects of digoxin is still a possibility. Here is a good look at the possible adverse effects, and measures that are required to mitigate and prevent serious consequences.

Overview and side effects of digoxin

Belonging to the category of cardiac glycosides, the drug is prescribed for treatment of heart failure. This is specifically used for treating patients with mild or moderate conditions and is also used for controlling the ventricular response rate in cases of chronic atrial fibrillation. Before we look at the side effects of digoxin, it is necessary to learn more about the medication and its mechanism of action. Extracted from the digitalis plant, the drug works by inhibiting the Na-K ATPase enzyme, and this inhibition is responsible for the beneficial effects of the medication. Sodium, potassium and calcium is regulated by the enzyme and this results in an increase in heart function. Specifically, the contractile force of the heart is increased, helping manage mild to moderate heart disease.

Additionally, the drug also works by stimulating the parasympathetic nervous system helping regulate heart rate. Atrial fibrillation is a disorder that affects the heart rhythm which in turn impacts the flow of blood to the heart. The drug is used for managing the condition, and apart from the above, is also prescribed for congestive heart failure, hypertensive congestive heart failure. The medication is also used in the treatment of hypertensive heart failure that ends up causing renal disease.

Individuals with conditions that make the medication unsuitable for use

In addition to possible side effects of digoxin, individuals with certain conditions may find the medication to be unsuitable. For instance, the medication is not suitable for individuals a history of allergies. Similarly, while the medication is prescribed for treating atrial fibrillation, it is not suitable for individuals with ventricular fibrillation. Other conditions that make the medication unsuitable for use include patients who have had a heart attack, individuals with AV block or serious heart conditions, and individuals with slow heartbeats that cause patients to faint. The medication is not suitable for patients with Wolff-Parkinson-White-Syndrome, a condition that causes a rapid increase in heartbeats. Other conditions include impaired kidneys, imbalance in electrolyte levels, and disorders of the thyroid. Patients who have had bouts of vomiting or diarrhea prior to treatment regimen are also advised to avoid taking the medication.

Commonly reported side effects of digoxin

Here is a compilation of commonly reported side effects of digoxin. It is important to note that the undesirable effects compiled below are possible effects and the actual experience or manifestation differs from individual to individual Some may experience mild or moderate effects, while some may experience serious effects, and in some instances, there is also the possibility of individuals not experiencing any effects whatsoever. Effects that are commonly reported include a pounding heart beat, while in other individuals the rate and patter of heart beat may be irregular and racy. Contrastingly, many individuals also report a reduction in heart rate, while other report feeling dizzy or faint. These conditions are typically not attributable to other health related conditions.

Apart from the above, there is also the possibility of individuals experiencing certain side effects of digoxin that occur with less frequency. There is the possibility of the manifestation of reddish spots on the and in some instances, it could be the outbreak of rashes that are either raised in nature or flat on the skin. Patients are also known to experience sudden severe pain in the stomach, while some end up with bleeding gums. There is also the possibility of discoloration of the stools, with a distinct dark and tarry appearance. Traces of blood either in the urine or in stools are another possible rare occurrence. As a result of the mechanism of action of the medication, individuals may find themselves getting bruised easily, with the possibility of bleeding. Some of the side effects of digoxin mentioned above may not actually require any kind of medical intervention and may resolve naturally. However, in certain instances, it is possible that the patient may require treatment or care at a healthcare facility, depending on the severity of the side effect or if it is persistent in nature.

In addition to the above side effects of digoxin there is also the possibility of certain undesirable effects being experienced by individuals with reduced frequency of occurrence. For instance, the individuals may exhibit an agitated conduct or may come across as being easily provoked into a combative reaction. Feelings of confusion, or anxiety or some form of depression is also a possibility. Additionally, individuals are prone to hallucinate when on the medication, while many are known to vomit. In certain instances, the vomit may contain traces of blood.

Side effects of digoxin : drug interactions

Apart from known and unknown side effects of digoxin, there is also the possibility of the drug interacting with other medications. Drug interactions occur when the ingredients in one medication impact the mechanism of action of other medications. For instance, drugs are intended to be removed from the body after the desired side effects, when the removal of the drug is either prolonged or shortened due to other medications, there is the possibility of the desired outcome being affected, and in some cases, the side effects may be amplified. For instance, certain drugs such as azole antifungal medications and macrolide antibiotics impact the removal of digoxin from the body. Other drug interactions include the possibility of an aggravation of the condition. For instance, non-steroidal anti-inflammatory drugs,  medications for cough and common cold could end up aggravating the heart condition. It is therefore necessary to avoid the drugs that interact with the medication. When two drugs or categories of drugs interact with each other, patients typically choose to continue the drug that has a more important desired outcome. Medications that are intended to treat more serious conditions are continued, while medications with a relatively less important desired outcome are discontinued.

The right dosage to prevent side effects of digoxin

One of the most common reasons for side effects of digoxin or any other drug is possible incorrect dosage. Specialists prescribe different doses depending on various factors, including the condition being treated, the age and gender of patient, other co-morbidities diagnosed in the patient, and the use of other medications. The dosages mentioned below are average ideal dosages, while the actual dosage may differ, depending on the actual condition. The recommended doses are intended to serve as a reference and an upper limit for patients diagnosed with various conditions and are not to be regarded as the final or specific doses.

Individuals diagnosed with heart failure or atrial fibrillation are typically recommended a dosage that is calculated on the basis of body weight. Patients above the age of 10 are generally prescribed an initial dose of 10 mcg (micrograms) for every kilo of body weight, and the dose is regulated by the specialist during the course of the treatment. The maintenance dose is typically lesser at 3 mcg per kilo of body weight. For patients between the ages of five and ten, with the same condition, the prescribed dose is 20 to 35 mcg per kilo of body weight, while the maintenance dose is upwards of 5.5 mcg per kilo of body weight. In the case of children between two to five years, the dose is 30 mcg per kilo of body weight with the maintenance dose around 9.3 mcg per kilo of body weight. Prevention of side effects of digoxin includes consuming the right dose, apart from avoiding incorrect remedial measures in the event of missed doses. Individuals are known to take a double dose to make up for a skipped dose. This is wrong practice and can lead to undesirable effects that are serious in nature.

Simple measures to avoid side effects of digoxin

Here is a compilation of simple measures to avoid side effects of digoxin. The medication is not to be stopped abruptly as this could trigger undesirable effects in the heart. The doses are to be taken as prescribed and patients are advised to be on the lookout for symptoms that indicate overdose. For instance, certain symptoms are indicative of overdose and patients are advised to report the same and seek medical intervention. Nausea, a sudden loss of appetite, and problems with vision are early indicators of possible overdose. Similarly, individuals are also likely to experience, confusion, bouts of diarrhea and vomiting as a result of excessive dosage. A clear change in heartbeat rate is also an indication of overdose. Changes in heart rhythm and a pounding sensation in the chest indicate that the individuals may have taken an excessive dose. I tis to be remembered that these symptoms are also some of the side effects of digoxin.

Additional side effects of digoxin with relatively unknown frequency of occurrence

Apart from the side effects of digoxin mentioned in earlier sections there are side effects that are also known to occur with relatively unknown frequency of occurrence. In other words, the exact frequency of occurrence is unknown, while the possibility is not entirely ruled out. Patients may exhibit an abnormal change in behavior, wherein there is an apparent loss of emotion. Similarly, the patient may experience sudden night blindness and lose interest in consuming food. Women may also end up experiencing a swelling in the breasts, or the breast may be sore to the touch. Weight loss as a result of lack of appetite is another possibility when the condition persists for a long duration. The impact of the medication on vision is higher with the possibility of multiple vision related effects. For instance, tunnel vision, double vision or an impact on the ability to clearly distinguish colors are also possibilities associated with the medication.

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