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Digoxin levels

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

In patients taking fixed daily dosage, steady state plasma concentrations vary widely making measurement desirable.

Therapeutic range (for 6 to 12h post dose) is 1.0 to 2.6nmol/l. Steady state occurs within 7 to 10 days (1).

Note that toxicity may occur with a level of less than 1.3nmol/l if there is hypokalaemia.

Features of toxicity include:

  • cardiac: especially ectopic arrhythmias and heart block, particularly in combination

  • non-cardiac effects: nausea, vomiting, anorexia, and (particularly in the elderly), diarrhoea, Occasionally confusion and delirium can occur. Colour vision abnormalities are rare

Reference:

  1. Doctor (1/8/2002), 34.
  2. British Heart Foundation (Factfile 7/2001). The use of digoxin.

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