toxicity within the therapeutic range

Last reviewed 10/2022

Toxicity is more likely within the therapeutic range if:

  • hypokalaemia and hypomagnesaemia (separately or in combination) - favour ectopic rhythms
  • hypercalcaemia - calcium has similar cardiac effects to digoxin
  • hyperkalaemia - promotes A-V block
  • plasma creatinine greater than 150 micromol/l
  • age greater than 60 years
  • daily maintenance dose greater than 6 micrograms/kg - for example, 365 micrograms for 60 kg patient
  • the patient has hypoxaemic acidaemia
  • the patient is hypothyroid