Digitalis is a medication prescribed to certain heart patients. Digitalis toxicity is a complication of digitalis therapy, or it may be occur when someone takes too much of the drug at one time. (This is called an acute ingestion.)

The most common prescription form of this medication is called digoxin. Digitoxin is another form of digitalis.

• Confusion
• Irregular pulse
• Loss of appetite
• Nausea, vomiting, diarrhea
• Palpitations
• Vision changes (unusual), including blind spots, blurred vision, changes in how colors look, or seeing spots)

Other symptoms may include:

• Decreased consciousness
• Decreased urine output
• Difficulty breathing when lying down
• Excessive nighttime urination
• Overall swelling

The doctor or nurse will examine you.

Your heart rate may be rapid or slow and irregular.

An ECG is done to check for irregular heart beats.

Blood tests that will be done include:

• Blood chemistry
• Kidney function tests including BUN and creatinine
• Digitoxin and digoxin test to check levels
• Potassium level
• Magnesium level

If the person is having trouble breathing, start CPR and get emergency medical help.

At the hospital, symptoms will be treated as appropriate.

If toxicity is due to a recent one-time exposure, treatment may involve:

• Activated charcoal
• Tube through the mouth into the stomach to wash out the stomach (gastric lavage)

Digitoxin blood levels may be lowered with repeated doses of charcoal, given after gastric lavage.

Methods to cause vomiting are usually not done because vomiting can worsen slow heart rhythms.

In severe cases, medications called digoxin-specific antibodies may be prescribed. Dialysis may be needed to reduce the levels of digitalis in the body.

How well a person does depends on the severity of the toxicity and if it has caused heart arrhythmias .

• Arrhythmias, which may be deadly
• Heart failure

Call your health care provider if you are taking a digitalis medication and you have symptoms of toxicity.

If you take digitalis medicine, you should have your blood levels checked regularly. Blood chemistries should also be monitored to check for conditions that make this toxicity more common.

Potassium supplements may be prescribed if you take diuretics and digitalis together. Or, a potassium-sparing diuretic may be prescribed.

Bain BJ. Acute poisoning. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 110.