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

Sources: 

• 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