Clinical Information

Digoxin is a potent cardiac glycoside widely prescribed for the treatment of patients suffering from congestive heart failure, as well as some types of cardiac arrhythmias. Digoxin toxicity is a common and serious problem in the clinical setting. This is because cardiac glycosides have a low therapeutic ratio (a very small difference between therapeutic and tissue toxic levels). Combined with the narrow therapeutic range is a marked patient variability in response to the same dosage of drug, often resulting in unpredictable serum drug levels. Symptoms of digoxin toxicity are often undistinguishable from the original condition for which the drug was prescribed. It may not be immediately apparent whether the patient has been under or overdosed. Monitoring serum digoxin levels combined with other clinical data can provide the physician with useful information to aid in adjusting the patient's dosage and achieving optimal therapeutic effect while avoiding useless subtherapeutic or harmful toxic dosage levels.