What are the causes of digoxin toxicity?

Causes of digoxin toxicity

  • Electrolyte disturbances
    • Hypokalaemia
    • Hypomagnesaemia
    • Hypercalcaemia
  • Hypothyroidism
  • Renal impairment
  • Dehydration secondary to acute infection
  • Drugs:
    • Amiodarone: Increases plasma levels by displacing it from the binding proteins
    • Calcium antagonists (e.g verapamil can reduce the renal excretion by up to 100%)
    • Ciclosporin
    • Quinidine
    • ACE inhibitors: May reduce the renal clearance


  • Rapid review of clinical medicine for MRCP part 2, 2nd Edition, by Sanjay Sharma and Rashmi Kaushal; Q 68, 226 
  • Davidson's Principles and Practice of Medicine; 23rd Edition; Page 140

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