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In adults with heart disease, clinical observations suggest that an overdose of digoxin of 10-15 mg results in death of half of patients.

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Unsurprisinglythe UK media was vigorous in highlighting the potential dangers of digoxinHoweverthey did take the responsible step of advising readers not to stop taking digoxin without first consulting their GP.

As per ACCF/AHA guidelinesa loading dose to initiate digoxin therapy in patients with heart failure is not necessary.

While taking this drugyour doctor may tell you to take and record your pulse dailyHe or she will tell you how rapid your pulse should beIf your pulse is slower than recommendedcontact your doctor about taking digoxin that dayKeep all appointments with your doctor and the laboratory so your response to the drug can be monitoredYou may have electrocardiogramsECGsand blood testsand your dose may be adjustedThis medication may cause drowsinessDo not drive a car or operate machinery until you know how this drug affects you.

These are important findings in terms of trying to quantify the size of the increased riskHoweverthere are points to consider:

Store at room temperature away from light and moistureDo not store in the bathroomKeep all medications away from children and pets.

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however, the data from the dig trial have served to demonstrate that digoxin reduces mortality in concentrations below 1 ng ml, and increases mortality in higher concentrations 3 .

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