Arrhythmias

Drug level monitoring of digoxin is recommended because it has a narrow therapeutic index and therefore should be used with caution in the elderly and in renal impairment. Therapeutic concentration results should be interpreted alongside clinical findings and serum potassium levels. Measurement of digoxin levels should be taken at least 6 hours post dose. MTW: see local Therapeutic Drug Monitoring Guidance.

Patients are at an increased risk of digoxin toxicity if hypokalaemia occurs.

Administration route: when changing from tablets to elixir, ONE 62.5micrograms tablet is approximately equivalent to 50micrograms(1mL) elixir.

Amiodarone requires careful monitoring. See BNF for cautions, side effects, interactions and monitoring.

Dronedarone is a derivative of amiodarone. It must be used second line to other anti-arrhythmic agents including amiodarone. See BNF for cautions, side effects, interactions and monitoring. There is a shared care guideline for prescribing, please see here.