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Digoxin: Interactions and Toxicities

- Digoxin metabolism is Inhibited by: 
- Erythromycin 
- Tetracycline 
- quinidine may double Dig levels; 
- Verapamil and Amiodarone 
- Hypokalemia and HypoMagnesemia and Hypoxia will potentiate toxicity, 
- Digoxin bioavailability is decreased by: 
- cholestyramine, 
- KAOLIN-pectin 
- antacids; 
- Can cause heart block
- Toxicity = N/V, diarrhea, HA, GI symptoms, anorexia, pyschiatric, fatique, visual lesions (yellow-green halos around lights) & cardiac arrthymia